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1740948116
MARCUS KYLE CARLOS FAJARDO
HERMOSA BEACH, CA
NPI
1740948116
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-12-02
Last Update Date
2021-12-02
Business Address
MARCUS KYLE CARLOS FAJARDO
1601 HERMOSA AVE # CA90254
HERMOSA BEACH, CA 90254
Phone number: 213-320-7037
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Mailing Address
MARCUS KYLE CARLOS FAJARDO
21600 OXNARD ST
WOODLAND HILLS, CA 91367-4976
Phone number: 818-345-2345
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