Jacob Phillips
Behavior Analyst in Huntington Beach, CA. Individual provider (NPI-1).
NPI number1164092698
StatusActive
Last updated in NPPESJun 28, 2021
Details
- NPI
- 1164092698
- Entity type
- Individual (NPI-1)
- Name
- Jacob Phillips
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 28, 2021
- Certification date
- Jun 28, 2021
- Last updated
- Jun 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | – | – | Yes |
Practice location
17421 Lido LnHuntington Beach, CA 92647-6143
Phone 714-307-2309
Mailing address
17421 Lido LnHuntington Beach, CA 92647-6143
Phone 714-307-2309
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