Healthcare Provider Details

I. General information

NPI: 1679248371
Provider Name (Legal Business Name): PJD ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28517 SANTA CATARINA RD
SANTA CLARITA CA
91350-3867
US

IV. Provider business mailing address

28517 SANTA CATARINA RD
SANTA CLARITA CA
91350-3867
US

V. Phone/Fax

Practice location:
  • Phone: 661-714-7639
  • Fax:
Mailing address:
  • Phone: 661-714-7639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PAUL JOSEPH BORDA
Title or Position: FOUNDING PARTNER
Credential:
Phone: 661-714-7639