Individual
KIZITO AZUKA AGBOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3100 DELTA FAIR BLVD, ANTIOCH, CA 94509-4001
(925) 709-6060
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
12/11/2019
Last updated
12/11/2019
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