Healthcare Provider Details

I. General information

NPI: 1912857228
Provider Name (Legal Business Name): ADRIAN HUERTA JR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1737 ATLANTA AVE
RIVERSIDE CA
92507-2442
US

IV. Provider business mailing address

7141 WOODLEY AVE
VAN NUYS CA
91406-3932
US

V. Phone/Fax

Practice location:
  • Phone: 818-285-8252
  • Fax: 818-273-1831
Mailing address:
  • Phone: 818-285-8252
  • Fax: 818-273-1831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: