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General NPI Number Information
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NPI Number | 1699983908
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Entity Type | Individual
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Provider Name | MR. ANIBAL JESUS MUNETON
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 2934 N FRESNO ST
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City | FRESNO
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State | CA
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Zip | 93703-1123
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Country | US
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Telephone | 559-549-6697
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Fax |
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Provider Business Mailing Address
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Address Line | 606 W. 39TH ST.
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City | LONG BEACH
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State | CA
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Zip | 90806-1316
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Country | US
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Telephone | 562-881-9901
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 126566
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License Number State | CA
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