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1124668843
JOHNNY GABRIEL DOMINGUEZ
MORENO VALLEY, CA
NPI
1124668843
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA RBT-19-107375)
Enumeration Date
2020-01-10
Last Update Date
2020-01-28
Business Address
JOHNNY GABRIEL DOMINGUEZ
12125 DAY ST STE E301
MORENO VALLEY, CA 92557-6704
Phone number: 951-344-2166
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Mailing Address
JOHNNY GABRIEL DOMINGUEZ
21600 OXNARD ST
WOODLAND HILLS, CA 91367-4976
Phone number: 818-345-2345
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