Healthcare Provider Details
I. General information
NPI: 1316488349
Provider Name (Legal Business Name): AMBITIONS BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/09/2017
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
111 DEERWOOD RD STE 115
SAN RAMON CA
94583-4445
US
IV. Provider business mailing address
2372 MORSE AVE # 534
IRVINE CA
92614-6234
US
V. Phone/Fax
- Phone: 949-325-4402
- Fax:
- Phone: 408-373-6752
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BILLAL
ASGHAR
Title or Position: CEO
Credential:
Phone: 949-325-4402