| NPI | 1639787393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA K FUNK Credentialing/Contracting 949-422-3609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 106E00000X Assistant Behavior Analyst | |
| 106S00000X Behavior Technician | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2021-03-18 |