Individual provider · NPI-1

Mark Ackerman

Technician, Other · San Diego, CA

NPI number1548778111
StatusActive
Last updated in NPPESJan 17, 2018

Details

NPI
1548778111
Entity type
Individual (NPI-1)
Name
Mark Ackerman
Sex
Male
Sole proprietor
No
Enumeration date
Jan 17, 2018
Last updated
Jan 17, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
247200000X Technician, Other15-05905CAYes
106S00000X Behavior Technician15-05905CA

Practice location

4669 Murphy Canyon Rd Ste 212
San Diego, CA 92123-4333

Phone 858-569-0056 · Fax 858-569-4233

Mailing address

4669 Murphy Canyon Rd Ste 212
San Diego, CA 92123-4333

Phone 858-569-0056 · Fax 858-569-4233

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Other Technician, Other providers in San Diego, CA