Leslie Phung
Behavior Technician in San Jose, CA. Individual provider (NPI-1).
NPI number1669962007
StatusActive
Last updated in NPPESMay 10, 2018
Details
- NPI
- 1669962007
- Entity type
- Individual (NPI-1)
- Name
- Leslie Phung
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 10, 2018
- Last updated
- May 10, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1401 Parkmoor Ave Ste 208San Jose, CA 95126-3407
Phone 408-885-0805
Mailing address
2264 Emerald Hills CirSan Jose, CA 95131-2611
Phone 785-217-8252
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