Individual
AGUSTIN MAX VELASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5501 ANTIQUE ROSE WAY, RIVERBANK, CA 95367-9505
(209) 863-2450
Mailing address
PO BOX 399318, SAN FRANCISCO, CA 94139-9318
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
CA
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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