Most Relevant Information
Provider Data
| NPI Number: | 1003375593 |
| Provider Name: | RAUL OMAR ROMAN RODRIGUEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/14/2019 |
| Last Updated: | 03/14/2019 |
Provider Practice Location
713 W COMMONWEALTH AVE
FULLERTON
CA
928321612
Practice Location Phone/Fax
| Phone: | 7148794274 |
| Fax: |
Provider Mailing Location
713 W COMMONWEALTH AVE
FULLERTON
CA
928321612
Provider Mailing Phone/Fax
| Phone: | 7148794274 |
| Fax: |