| Passport To Adaptive Living | |
|
1673 Donlon St Ste 204 Ventura CA 93003-5668 | |
| (805) 339-0210 | |
| (805) 642-3757 |
| Full Name | Passport To Adaptive Living |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1673 Donlon St Ste 204, Ventura, California |
| Authorized Official Name and Position | Wilson Jeremy (DIRECTOR) |
| Authorized Official Contact | 8053390210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Passport To Adaptive Living 1673 Donlon St Ste 204 Ventura CA 93003-5668 Ph: (805) 339-0210 | Passport To Adaptive Living 1673 Donlon St Ste 204 Ventura CA 93003-5668 Ph: (805) 339-0210 |
| NPI Number | 1952661241 |
|---|---|
| Provider Enumeration Date | 05/21/2012 |
| Last Update Date | 05/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952661241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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