Most Relevant Information
Provider Data
| NPI Number: | 1003524315 |
| Provider Name: | JUSTYN TYLER GELACIO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/07/2022 |
| Last Updated: | 11/07/2022 |
Provider Practice Location
9844 RESEARCH DR STE 100
IRVINE
CA
926184381
Practice Location Phone/Fax
| Phone: | 8184726679 |
| Fax: |
Provider Mailing Location
662 ENCINITAS BLVD STE 208
ENCINITAS
CA
920246789
Provider Mailing Phone/Fax
| Phone: | 7606341125 |
| Fax: | 7606341530 |