Provider Demographics
NPI:1164177861
Name:MUNOZ, ERIC SEBASTIAN
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:SEBASTIAN
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13440 VENTURA BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-6158
Mailing Address - Country:US
Mailing Address - Phone:818-442-0921
Mailing Address - Fax:
Practice Address - Street 1:36891 COOK ST STE 6
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6110
Practice Address - Country:US
Practice Address - Phone:760-610-6115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst