MEDICARE: VICTORIA JOO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1124650569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA JOO

Provider Business Mailing Address
First Line	:	12792 VALLEY VIEW ST STE 205
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-2510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12792 VALLEY VIEW ST STE A
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-2509
Country	:	US
Telephone Number	:	714-336-3663
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2020
Last Update Date	:	10/28/2022

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Directions to “ VICTORIA JOO ” Practice Location

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