Jake Love
Behavior Technician in Corona, CA. Individual provider (NPI-1).
NPI number1053923904
StatusActive
Last updated in NPPESAug 21, 2020
Details
- NPI
- 1053923904
- Entity type
- Individual (NPI-1)
- Name
- Jake Love
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 21, 2020
- Certification date
- Aug 21, 2020
- Last updated
- Aug 21, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
255 E Rincon St Ste 219Corona, CA 92879-1387
Phone 714-873-9543
Mailing address
255 E Rincon St Ste 219Corona, CA 92879-1387
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