Most Relevant Information
Provider Data
| NPI Number: | 1003643230 |
| Provider Name: | JOSE RAFAEL FUENTES |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/19/2024 |
| Last Updated: | 09/19/2024 |
Provider Practice Location
400 CONCAR DR STE 4-134
SAN MATEO
CA
944022681
Practice Location Phone/Fax
| Phone: | 6509316300 |
| Fax: |
Provider Mailing Location
400 CONCAR DR STE 4-134
SAN MATEO
CA
944022681
Provider Mailing Phone/Fax
| Phone: | 6509316300 |
| Fax: |