Healthcare Provider Details

I. General information

NPI: 1619772167
Provider Name (Legal Business Name): GOOD HABITS EDUCATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 E FOOTHILL BLVD
UPLAND CA
91786-4029
US

IV. Provider business mailing address

710 E FOOTHILL BLVD
UPLAND CA
91786-4029
US

V. Phone/Fax

Practice location:
  • Phone: 626-886-5678
  • Fax:
Mailing address:
  • Phone: 626-567-5678
  • 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 Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WEI ZHAO
Title or Position: OWNER
Credential:
Phone: 626-567-5678