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Organization
PRISM BEHAVIOR
Active
Organization
PRISM BEHAVIOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE ILAGAN (BEHAVIORAL TECHNICAN)
(818) 493-8318
Entity
Organization
Contact information
Practice address
21600 OXNARD ST STE 1030, WOODLAND HILLS, CA 91367-5085
(818) 493-8318
Mailing address
21600 OXNARD ST STE 1030, WOODLAND HILLS, CA 91367-5085
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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