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NPI Code Detail

MEDICARE: DENISSE YVONNE GUDINO

MEDICARE: DENISSE YVONNE GUDINO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1538763388
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISSE YVONNE GUDINO
Provider Business Mailing Address
First Line : 1219 LOMITA BLVD STE 104-106
Second Line :
City : HARBOR CITY
State : CA
Zip : 90710-2111
Country : US
Telephone Number : 424-328-5297
Fax Number :
Provider Business Practice Location Address
First Line : 1219 LOMITA BLVD STE 104-106
Second Line :
City : HARBOR CITY
State : CA
Zip : 90710-2111
Country : US
Telephone Number : 424-328-5297
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2020
Last Update Date : 11/23/2020

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Directions to “ DENISSE YVONNE GUDINO ” Practice Location

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