| Xtraordinary Spot | |
|
4372 Almaterra Dr Perris CA 92571-5112 | |
| (562) 235-7456 | |
| Not Available |
| Full Name | Xtraordinary Spot |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4372 Almaterra Dr, Perris, California |
| Authorized Official Name and Position | Sarde Stewart (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9099978496 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Xtraordinary Spot 124 Pine Ct Perris CA 92571-2673 Ph: (909) 997-8496 | Xtraordinary Spot 4372 Almaterra Dr Perris CA 92571-5112 Ph: (562) 235-7456 |
| NPI Number | 1215645833 |
|---|---|
| Provider Enumeration Date | 11/14/2022 |
| Last Update Date | 11/14/2022 |
| Certification Date | 11/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215645833 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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