Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 106S00000X | Behavior Technician |
NPI | 1003323668 |
---|---|
Provider Name | George Quan |
First Address | Irvine, CA 92606-2417 |
Second Address | Irvine, CA 92606-2417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2018 |
Last Update Date | 09/10/2018 |