Healthcare Provider Details

I. General information

NPI: 1558941096
Provider Name (Legal Business Name): ANTONIO PASIMIO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N HILL AVE STE 100
PASADENA CA
91106-1949
US

IV. Provider business mailing address

50 N HILL AVE STE 100
PASADENA CA
91106-1949
US

V. Phone/Fax

Practice location:
  • Phone: 626-793-7770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: