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1417525056
ANGEL HEREDIA
SAN JOSE, CA
NPI
1417525056
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
106S00000X Behavior Technician
Enumeration Date
2021-06-10
Last Update Date
2023-02-23
Business Address
ANGEL HEREDIA
425 E SANTA CLARA ST
SAN JOSE, CA 95113-1936
Phone number: 408-800-4095
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Mailing Address
ANGEL HEREDIA
425 E. TAYLOR STREET
SAN JOSE, CA 95113
Phone number: 408-800-4095
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