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Individual

MARK ACKERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4669 MURPHY CANYON RD STE 212, SAN DIEGO, CA 92123-4333
(858) 569-0056
(858) 569-4233
Mailing address
4669 MURPHY CANYON RD STE 212, SAN DIEGO, CA 92123-4333
(858) 569-0056
(858) 569-4233

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
15-05905
CA
247200000X
Other Technician
Primary
15-05905
CA

Other

Enumeration date
01/17/2018
Last updated
01/17/2018
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