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Organization

PORTVIEW PREPARATORY, INC.

Active
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Organization

PORTVIEW PREPARATORY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDWARD MIGUEL BCBA (CEO)
(714) 463-6390
Entity
Organization

Contact information

Practice address
1361 VALENCIA AVE, TUSTIN, CA 92780-6459
(714) 463-6390
Mailing address
1361 VALENCIA AVE, TUSTIN, CA 92780-6459
(714) 463-6390

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—

Other

Enumeration date
04/14/2021
Last updated
01/05/2023
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