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General NPI Number Information
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NPI Number | 1568140473
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Entity Type | Individual
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Provider Name | JHON STIWAR ORTEGA AYALA
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Gender | Male
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 13100 IRISBEND AVE
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City | EASTVALE
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State | CA
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Zip | 92880-3065
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Country | US
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Telephone | 323-539-1464
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 LA SIERRA AVE APT 27
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City | RIVERSIDE
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State | CA
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Zip | 92505-2950
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Country | US
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Telephone | 951-454-2369
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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