Healthcare Provider Details

I. General information

NPI: 1073861258
Provider Name (Legal Business Name): REACH BEHAVIOR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2012
Last Update Date: 04/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13331 GARDEN GROVE BLVD SUITE E
GARDEN GROVE CA
92843-2254
US

IV. Provider business mailing address

11770 WARNER AVE SUITE 214
FOUNTAIN VALLEY CA
92708-2663
US

V. Phone/Fax

Practice location:
  • Phone: 714-235-1936
  • Fax:
Mailing address:
  • Phone: 714-235-1936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANH THI PHAN-CHU
Title or Position: DIRECTOR
Credential: M.S., BCBA
Phone: 714-235-1936