Most Relevant Information
Provider Data
| NPI Number: | 1003467978 |
| Provider Name: | TYESHA OSBORNE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/23/2019 |
| Last Updated: | 09/23/2019 |
Provider Practice Location
4210 N F ST APT 4
SAN BERNARDINO
CA
924073038
Practice Location Phone/Fax
| Phone: | 9513296253 |
| Fax: |
Provider Mailing Location
12235 BEACH BLVD
STANTON
CA
906803939
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |