Most Relevant Information
Provider Data
| NPI Number: | 1003595042 |
| Provider Name: | JICELLE ORTEGA EMIGDIO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/17/2023 |
| Last Updated: | 07/17/2023 |
Provider Practice Location
2400 W DUNLAP AVE
PHOENIX
AZ
850212817
Practice Location Phone/Fax
| Phone: | 6023252485 |
| Fax: |
Provider Mailing Location
21600 OXNARD ST STE 1800
WOODLAND HILLS
CA
913677807
Provider Mailing Phone/Fax
| Phone: | 8183452345 |
| Fax: |