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1821602392
JOSE ANTONIO IXTA-MATUTE
COVINA, CA
NPI
1821602392
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2020-09-02
Last Update Date
2020-09-02
Business Address
JOSE ANTONIO IXTA-MATUTE
210 N CITRUS AVE 1
COVINA, CA 91723
Phone number:
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Mailing Address
JOSE ANTONIO IXTA-MATUTE
7226 SEPULVEDA BLVD
VAN NUYS, CA 91405-2003
Phone number: 818-235-1414
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