Most Relevant Information
Provider Data
| NPI Number: | 1003680356 |
| Provider Name: | JOHANA REBECA NIETO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/07/2023 |
| Last Updated: | 11/07/2023 |
Provider Practice Location
612 S MYRTLE AVE STE 100
MONROVIA
CA
910163406
Practice Location Phone/Fax
| Phone: | 7609923039 |
| Fax: |
Provider Mailing Location
11911 HONEY HOLW
MORENO VALLEY
CA
925576107
Provider Mailing Phone/Fax
| Phone: | 5103742128 |
| Fax: |