Most Relevant Information
Provider Data
| NPI Number: | 1003307851 |
| Provider Name: | ALEXIA ELISSA BUSTAMANTE |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/27/2018 |
| Last Updated: | 05/27/2018 |
Provider Practice Location
3400 STATE ST STE G750
SALEM
OR
973017012
Practice Location Phone/Fax
| Phone: | 0000000000 |
| Fax: |
Provider Mailing Location
21600 OXNARD ST STE 1800
WOODLAND HILLS
CA
913677807
Provider Mailing Phone/Fax
| Phone: | 8183452345 |
| Fax: |