Healthcare Provider Details

I. General information

NPI: 1013630458
Provider Name (Legal Business Name): JOSHUA RAFAEL RECINOS-ALMANZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2338 W ROYAL PALM RD STE J
PHOENIX AZ
85021-9339
US

IV. Provider business mailing address

2002 IOWA AVE STE 106
RIVERSIDE CA
92507-2423
US

V. Phone/Fax

Practice location:
  • Phone: 855-772-8847
  • Fax:
Mailing address:
  • Phone: 949-309-1378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-83092
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: