Individual
MR. ANDY PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
13847 E 14TH ST STE 217, SAN LEANDRO, CA 94578-2626
(888) 805-0759
Mailing address
1333 S MAYFLOWER AVE STE 220, MONROVIA, CA 91016-4066
(888) 805-0759
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-21-56691
CA
Other
Enumeration date
04/06/2018
Last updated
12/21/2021
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