Individual
VIVIAN T PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1820 W ORANGEWOOD AVE STE 110, ORANGE, CA 92868-5056
(714) 696-2862
Mailing address
1820 W ORANGEWOOD AVE STE 110, ORANGE, CA 92868-5056
(714) 696-2862
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
06/10/2021
Last updated
10/24/2024
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