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1154100220
JACKIE ANTONIO HERNANDEZ
IRVINE, CA
NPI
1154100220
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-09-27
Last Update Date
2023-09-27
Business Address
JACKIE ANTONIO HERNANDEZ
16782 VON KARMAN AVE STE 11
IRVINE, CA 92606-2417
Phone number: 855-223-7123
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Mailing Address
JACKIE ANTONIO HERNANDEZ
PO BOX 33568
SAN DIEGO, CA 92163-3568
Phone number: 855-223-7123
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