Jason Emmanuel Lewis
Behavior Technician in Gardena, CA. Individual provider (NPI-1).
NPI number1982431177
StatusActive
Last updated in NPPESSep 19, 2024
Details
- NPI
- 1982431177
- Entity type
- Individual (NPI-1)
- Name
- Jason Emmanuel Lewis
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 19, 2024
- Certification date
- Sep 19, 2024
- Last updated
- Sep 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
879 W 190th St Ste 1000Gardena, CA 90248-4255
Phone 310-329-9115
Mailing address
1819 Charlie Sifford DrLos Angeles, CA 90047-5102
Phone 310-901-0446
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