Gustavo Avila

Individual provider Active NPI Behavior Technician · Hesperia, CA

NPI 1578288767 · NPPES record last updated Nov 30, 2024

Key facts

NPI
1578288767
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
9390 Hesperia Rd Ste 2
Hesperia, CA 92345-3636
Phone
(800) 207-0272
NPI assigned
Oct 10, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

9390 Hesperia Rd Ste 2
Hesperia, CA 92345-3636

Mailing address

1301 E Orangewood Ave
Anaheim, CA 92805-6807

Other practice location 1

4950 San Bernardino St Ste 101
Montclair, CA 91763-2328
Phone (800) 249-1266

Other providers in Hesperia, CA

All providers in Hesperia, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.