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1871226936
JACK BIVENS
IRVINE, CA
NPI
1871226936
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-07-06
Last Update Date
2022-07-06
Business Address
JACK BIVENS
106 DISCOVERY
IRVINE, CA 92618-3131
Phone number: 949-203-8872
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Mailing Address
JACK BIVENS
21600 OXNARD ST STE 1800
WOODLAND HILLS, CA 91367-7807
Phone number: 818-345-2345
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