Most Relevant Information
Provider Data
| NPI Number: | 1003317959 |
| Provider Name: | ASIAH FORTUNA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/26/2018 |
| Last Updated: | 02/26/2018 |
Provider Practice Location
18350 MOUNT LANGLEY ST STE 105
FOUNTAIN VALLEY
CA
927086923
Practice Location Phone/Fax
| Phone: | 8182416780 |
| Fax: | 8182416853 |
Provider Mailing Location
206 N JACKSON ST STE 202
GLENDALE
CA
912064330
Provider Mailing Phone/Fax
| Phone: | 8182416780 |
| Fax: | 8182416853 |