Organization
AVITA NOVA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA R. HOLDING PH.D., BCBA (OWNER)
(949) 939-8032
Entity
Organization
Contact information
Practice address
1202 BELLECOUR WAY, LAKE FOREST, CA 92630-7944
(949) 939-8032
(949) 525-4759
Mailing address
1202 BELLECOUR WAY, LAKE FOREST, CA 92630-7944
(949) 939-8032
(949) 525-4759
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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