| Shoreline Aba | |
|
377 Blue Dolphin Dr Port Hueneme CA 93041-3537 | |
| (805) 341-9214 | |
| Not Available |
| Full Name | Shoreline Aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 377 Blue Dolphin Dr, Port Hueneme, California |
| Authorized Official Name and Position | Michelle L Evans (EXECUTIVE DIRECTOR / OWNER) |
| Authorized Official Contact | 8053419214 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoreline Aba 377 Blue Dolphin Dr Port Hueneme CA 93041-3537 Ph: (805) 341-9214 | Shoreline Aba 377 Blue Dolphin Dr Port Hueneme CA 93041-3537 Ph: (805) 341-9214 |
| NPI Number | 1003369687 |
|---|---|
| Provider Enumeration Date | 07/29/2016 |
| Last Update Date | 08/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003369687 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |