| Easter Seals Southern California, Inc | |
|
1063 Mcgaw Ave Ste 100 Irvine CA 92614-5554 | |
| (714) 834-1111 | |
| (714) 834-1128 |
| Full Name | Easter Seals Southern California, Inc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1063 Mcgaw Ave Ste 100, Irvine, California |
| Authorized Official Name and Position | Susan Berglund (CFO) |
| Authorized Official Contact | 7148341111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easter Seals Southern California, Inc 1063 Mcgaw Ave Ste 100 Irvine CA 92614-5554 Ph: (714) 834-1111 | Easter Seals Southern California, Inc 1063 Mcgaw Ave Ste 100 Irvine CA 92614-5554 Ph: (714) 834-1111 |
| NPI Number | 1619255841 |
|---|---|
| Provider Enumeration Date | 07/21/2011 |
| Last Update Date | 09/08/2021 |
| Certification Date | 09/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619255841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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