| Innovative Vitality Aba Inc. | |
|
11211 Rancho Cordova St Bakersfield CA 93311-9128 | |
| (661) 477-5977 | |
| Not Available |
| Full Name | Innovative Vitality Aba Inc. |
|---|---|
| Speciality | Behavior Analyst |
| Location | 11211 Rancho Cordova St, Bakersfield, California |
| Authorized Official Name and Position | Namaz Habroun (OWNER) |
| Authorized Official Contact | 6614775977 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Vitality Aba Inc. 11211 Rancho Cordova St Bakersfield CA 93311-9128 Ph: (661) 477-5977 | Innovative Vitality Aba Inc. 11211 Rancho Cordova St Bakersfield CA 93311-9128 Ph: (661) 477-5977 |
| NPI Number | 1407681109 |
|---|---|
| Provider Enumeration Date | 09/04/2024 |
| Last Update Date | 09/04/2024 |
| Certification Date | 09/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407681109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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