Organization
BEHAVIORAL INNOVATION IN NURSING PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELICIA PONDER (ADMINISTRATOR)
(951) 315-1265
Entity
Organization
Contact information
Practice address
14023 PARAMOUNT BLVD, PARAMOUNT, CA 90723-2605
(562) 331-8881
(562) 988-3373
Mailing address
14023 PARAMOUNT BLVD, PARAMOUNT, CA 90723-2605
(562) 331-8881
(562) 988-3373
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
03/27/2020
Last updated
05/18/2020
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