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1043851942
ILSE IVETTE DIAZ
IRVINE, CA
NPI
1043851942
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA Y2572492)
Enumeration Date
2019-10-01
Last Update Date
2019-10-01
Business Address
ILSE IVETTE DIAZ
106 DISCOVERY
IRVINE, CA 92618-3131
Phone number: 949-203-8872
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Mailing Address
ILSE IVETTE DIAZ
26503 PASEO SAN GABRIEL
SAN JUAN CAPISTRANO, CA 92675-2317
Phone number:
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