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NPI Code Detail

MEDICARE: MR. MUCIO ANTONIO MORIN JR.

MEDICARE: MR. MUCIO ANTONIO MORIN JR.
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
1101Y00000XCounselor
2103K00000XBehavior Analyst
3106E00000XAssistant Behavior Analyst

General Provider Information

NPI Number : 1780877399
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MUCIO ANTONIO MORIN JR.
Provider Business Mailing Address
First Line : 255 E RINCON ST STE 219
Second Line :
City : CORONA
State : CA
Zip : 92879-1387
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 255 E RINCON ST STE 219
Second Line :
City : CORONA
State : CA
Zip : 92879-1387
Country : US
Telephone Number : 951-817-5328
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2007
Last Update Date : 04/22/2023

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