Annie Lysaris Bustamante

NPI #1932744331 in Fontana, California

Provider Information

NPI Number: 1932744331
Entity Type: Individual
Name: Annie Lysaris Bustamante
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Nov 10, 2019
Last Updated: Nov 10, 2019

Practice Location

Address: 9027 FERNDALE AVE
City: Fontana
State: California
ZIP Code: 92335-6017
Phone: (909) 343-7779

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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