Provider Demographics
NPI:1558983411
Name:ARIZA, XAVIER MATHIAS
Entity Type:Individual
Prefix:
First Name:XAVIER
Middle Name:MATHIAS
Last Name:ARIZA
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 1:9360 SANTA ANITA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6151
Mailing Address - Country:US
Mailing Address - Phone:909-481-2080
Mailing Address - Fax:909-277-7882
Practice Address - Street 1:9360 SANTA ANITA AVE STE 100
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6151
Practice Address - Country:US
Practice Address - Phone:909-481-2080
Practice Address - Fax:909-277-7882
Is Sole Proprietor?:No
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician