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1376178921
JEVIN JUSTIN MATTATHIL
ELK GROVE, CA
NPI
1376178921
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA F4982661)
Enumeration Date
2020-03-04
Last Update Date
2020-03-04
Business Address
JEVIN JUSTIN MATTATHIL
2366 MARITIME DR
ELK GROVE, CA 95758-3639
Phone number: 916-365-4500
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Mailing Address
JEVIN JUSTIN MATTATHIL
21600 OXNARD ST STE 1800
WOODLAND HILLS, CA 91367-7807
Phone number:
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