Healthcare Provider Details

I. General information

NPI: 1043620784
Provider Name (Legal Business Name): JOSHUA TREVINO BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2014
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19772 MACARTHUR BLVD STE 200
IRVINE CA
92612-2405
US

IV. Provider business mailing address

802 N SAGE AVE
RIALTO CA
92376-4456
US

V. Phone/Fax

Practice location:
  • Phone: 949-739-0135
  • Fax: 949-739-0135
Mailing address:
  • Phone: 626-616-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: