Individual
JIMMY GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14425 EADBROOK DR, HACIENDA HEIGHTS, CA 91745-2559
(626) 315-8838
Mailing address
14425 EADBROOK DR, HACIENDA HEIGHTS, CA 91745-2559
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
Primary
—
CA
106S00000X
Behavior Technician
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
04/02/2019
Last updated
04/02/2019
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