Most Relevant Information
Provider Data
| NPI Number: | 1003487620 |
| Provider Name: | VICKY CHAN BCBA |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/06/2021 |
| Last Updated: | 07/06/2021 |
Provider Practice Location
6101 W CENTINELA AVE STE 380
CULVER CITY
CA
902306367
Practice Location Phone/Fax
| Phone: | 3103377827 |
| Fax: |
Provider Mailing Location
4880 MARKET ST
VENTURA
CA
930037783
Provider Mailing Phone/Fax
| Phone: | 8056587827 |
| Fax: |