Organization
PROGRESSIVE BEHAVIOR SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN MANVELL PRESIDENT,OWNER, SLP (OWNER AND SLP)
(714) 943-7146
Entity
Organization
Contact information
Practice address
3065 ROSECRANS PL STE 200, SAN DIEGO, CA 92110-4822
(714) 943-7146
Mailing address
3065 ROSECRANS PL STE 200, SAN DIEGO, CA 92110-4822
(714) 943-7146
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
—
—
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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