Individual
ALAN JAY FAULKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
7090 MIRATECH DR, SAN DIEGO, CA 92121-3109
(858) 304-6440
Mailing address
8672 VIA MALLORCA, LA JOLLA, CA 92037-0079
(559) 326-6244
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-82940Z
CA
Other
Enumeration date
04/01/2019
Last updated
04/01/2019
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