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1497511653
JOHNNY MICHAEL MEDINA
BRENTWOOD, CA
NPI
1497511653
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-02-26
Last Update Date
2024-02-26
Business Address
JOHNNY MICHAEL MEDINA
1191 CENTRAL BLVD STE A
BRENTWOOD, CA 94513-2253
Phone number: 855-223-7123
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Mailing Address
JOHNNY MICHAEL MEDINA
PO BOX 33568
SAN DIEGO, CA 92163-3568
Phone number: 855-223-7123
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