Individual
ANDRIA DANIELLE MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12440 FIRESTONE BLVD STE 316, NORWALK, CA 90650-9319
(562) 846-6367
Mailing address
12440 FIRESTONE BLVD STE 316, NORWALK, CA 90650-9319
(562) 846-6367
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSS-GDILXC
CA
373H00000X
Day Training/Habilitation Specialist
—
CA
Other
Enumeration date
01/09/2020
Last updated
09/29/2025
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