Individual
DR. BRIAN BOECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D, BCBA
Contact information
Practice address
5144 SAMMY HAGAR WAY, FONTANA, CA 92336-4628
(909) 618-5965
Mailing address
5144 SAMMY HAGAR WAY, FONTANA, CA 92336-4628
(909) 618-5965
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-38485
CA
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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