Most Relevant Information
Provider Data
| NPI Number: | 1003494907 |
| Provider Name: | BRYAN HEREDIA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/31/2021 |
| Last Updated: | 03/31/2021 |
Provider Practice Location
2342 PROFESSIONAL PKWY STE 300
SANTA MARIA
CA
934556819
Practice Location Phone/Fax
| Phone: | 8059799941 |
| Fax: |
Provider Mailing Location
2342 PROFESSIONAL PKWY STE 300
SANTA MARIA
CA
934556819
Provider Mailing Phone/Fax
| Phone: | 8059799941 |
| Fax: |