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Organization
THE CO-CREATIVE CENTER LLC
Active
Organization
THE CO-CREATIVE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY TSAI TRUONG BCBA (BEHAVIOR ANALYST)
(408) 768-9800
Entity
Organization
Contact information
Practice address
19712 MACARTHUR BLVD STE 101, IRVINE, CA 92612-2407
(949) 385-1656
Mailing address
19712 MACARTHUR BLVD STE 101, IRVINE, CA 92612-2407
(949) 385-1656
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427353317
BCBA
CA
Enumeration date
08/11/2021
Last updated
08/11/2021
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