Most Relevant Information
Provider Data
| NPI Number: | 1003489667 |
| Provider Name: | ANDREW RALPH DUFORT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/21/2021 |
| Last Updated: | 07/21/2021 |
Provider Practice Location
2670 N MAIN ST
SANTA ANA
CA
927056639
Practice Location Phone/Fax
| Phone: | 9493572556 |
| Fax: | 8555682494 |
Provider Mailing Location
18726 S WESTERN AVE STE 408
GARDENA
CA
902483858
Provider Mailing Phone/Fax
| Phone: | 3108560800 |
| Fax: | 8555682494 |