MR. Mauricio Antonio Portillo JR.

NPI #1063044311 in Northridge, California

Provider Information

NPI Number: 1063044311
Entity Type: Individual
Name: MR. Mauricio Antonio Portillo JR.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Feb 5, 2020
Last Updated: Feb 5, 2020

Practice Location

Address: 9335 RESEDA BLVD STE 101
City: Northridge
State: California
ZIP Code: 91324-2968
Phone: (818) 960-0635

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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