Organization
AUTISM SPECTRUM INTERVENTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOO HEE JULIE NAM BCBA (DIVISION CLINICAL SUPERVISOR)
(562) 405-6399
Entity
Organization
Contact information
Practice address
713 W COMMONWEALTH AVE STE C, FULLERTON, CA 92832-1612
(714) 879-4274
Mailing address
713 W COMMONWEALTH AVE STE A, FULLERTON, CA 92832-1612
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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