Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 106S00000X | Behavior Technician | RBT-18-50965 |
NPI | 1003318957 |
---|---|
Provider Name | Joshua Schwartz |
First Address | Berkeley, CA 94703-2715 |
Second Address | Santa Cruz, CA 95060-2178 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2018 |
Last Update Date | 06/08/2021 |