Most Relevant Information
Provider Data
| NPI Number: | 1003406810 |
| Provider Name: | KENNY JUNIOR RODRIGUEZ TRUJILLO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | MPSS-IJQGWM |
Most Important Dates
| Enumeration Date: | 01/25/2021 |
| Last Updated: | 04/08/2024 |
Provider Practice Location
250 BON AIR ROAD, UNIT B - 1ST FLOOR (ACCESS TEAM)
GREENBRAE
CA
94904
Practice Location Phone/Fax
| Phone: | 8888181115 |
| Fax: |
Provider Mailing Location
250 BON AIR ROAD, UNIT B - 1ST FLOOR (ACCESS TEAM)
GREENBRAE
CA
94904
Provider Mailing Phone/Fax
| Phone: | 8888181115 |
| Fax: |