Healthcare Provider Details

I. General information

NPI: 1831605807
Provider Name (Legal Business Name): PAIGE ARIMA-ANTRIM RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 12/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4880 MARKET ST
VENTURA CA
93003-7783
US

IV. Provider business mailing address

4880 MARKET ST
VENTURA CA
93003-7783
US

V. Phone/Fax

Practice location:
  • Phone: 805-826-1980
  • Fax: 805-650-1385
Mailing address:
  • Phone: 805-826-1980
  • Fax: 805-650-1385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-16-18716
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: