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1063044311
MAURICIO ANTONIO PORTILLO
NORTHRIDGE, CA
NPI
1063044311
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2020-02-05
Last Update Date
2020-02-05
Business Address
Mr. MAURICIO ANTONIO PORTILLO
9335 RESEDA BLVD STE 101
NORTHRIDGE, CA 91324-2968
Phone number: 818-960-0635
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Mailing Address
Mr. MAURICIO ANTONIO PORTILLO
21600 OXNARD ST STE 1800
WOODLAND HILLS, CA 91367-7807
Phone number: 818-345-2345
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