| Innovate Aba | |
|
5405 Alton Pkwy Ste 5a #430 Irvine CA 92604-3717 | |
| (714) 580-5969 | |
| Not Available |
| Full Name | Innovate Aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 5405 Alton Pkwy Ste 5a, Irvine, California |
| Authorized Official Name and Position | Brooke Tawanna (OWNER) |
| Authorized Official Contact | 7145805969 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovate Aba 5405 Alton Pkwy Ste 5a #430 Irvine CA 92604-3717 Ph: () - | Innovate Aba 5405 Alton Pkwy Ste 5a #430 Irvine CA 92604-3717 Ph: (714) 580-5969 |
| NPI Number | 1346863529 |
|---|---|
| Provider Enumeration Date | 05/22/2020 |
| Last Update Date | 05/22/2020 |
| Certification Date | 05/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346863529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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