Provider Demographics
NPI:1467093542
Name:UISECO, PAULO JOSEPH
Entity Type:Individual
Prefix:
First Name:PAULO
Middle Name:JOSEPH
Last Name:UISECO
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 1:20330 COLINA DR
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91351-6945
Mailing Address - Country:US
Mailing Address - Phone:661-310-6804
Mailing Address - Fax:
Practice Address - Street 1:20330 COLINA DR
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91351-6945
Practice Address - Country:US
Practice Address - Phone:661-310-6804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician