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1760020499
IVAN JOSEPH MUMM
FREMONT, CA
NPI
1760020499
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA 46-1305562)
Enumeration Date
2019-12-12
Last Update Date
2019-12-12
Business Address
IVAN JOSEPH MUMM
39210 STATE ST STE 220
FREMONT, CA 94538-1456
Phone number: 510-894-4135
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Mailing Address
IVAN JOSEPH MUMM
7620 MOUNTAIN BLVD APT 7
OAKLAND, CA 94605-3126
Phone number: 510-697-2921
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