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1316606452
JACKIE PHAN
RIVERSIDE, CA
NPI
1316606452
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-12-16
Last Update Date
2021-12-16
Business Address
JACKIE PHAN
2155 CHICAGO AVE STE 203
RIVERSIDE, CA 92507-2209
Phone number: 951-357-6926
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Mailing Address
JACKIE PHAN
18726 S WESTERN AVE STE 408
GARDENA, CA 90248-3858
Phone number: 310-856-0800
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