Shoreline Aba | |
377 Blue Dolphin Dr Port Hueneme CA 93041-3537 | |
(805) 341-9214 | |
Not Available |
Full Name | Shoreline Aba |
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Speciality | Behavior Analyst |
Location | 377 Blue Dolphin Dr, Port Hueneme, California |
Authorized Official Name and Position | Michelle L Evans (EXECUTIVE DIRECTOR / OWNER) |
Authorized Official Contact | 8053419214 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Shoreline Aba 377 Blue Dolphin Dr Port Hueneme CA 93041-3537 Ph: (805) 341-9214 | Shoreline Aba 377 Blue Dolphin Dr Port Hueneme CA 93041-3537 Ph: (805) 341-9214 |
NPI Number | 1003369687 |
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Provider Enumeration Date | 07/29/2016 |
Last Update Date | 08/01/2016 |
Identifier | Type | State | Issuer |
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1003369687 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | (* (Not Available)) | Primary |