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General NPI Number Information
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NPI Number | 1811456908
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Entity Type | Individual
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Provider Name | HITOMI MATOBA
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Gender | Female
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 4300 LATHAM ST STE 200
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City | RIVERSIDE
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State | CA
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Zip | 92501-4334
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Country | US
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Telephone | 951-779-5792
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Fax | 951-779-2915
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Provider Business Mailing Address
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Address Line | 6000 UNIVERSITY PKWY
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-2308
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Country | US
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Telephone | 909-273-4709
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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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