Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003395856 |
---|---|
Provider Name | Tiffany G Osterbur |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | Chula Vista, CA 91914-3551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2018 |
Last Update Date | 13/08/2018 |