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General NPI Number Information
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NPI Number | 1306321427
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Entity Type | Individual
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Provider Name | ARCHIE HOWARD II
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Gender | Male
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Dates
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Enumeration Date | 09/25/2018
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 10776 FREMONT ST
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City | YUCAIPA
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State | CA
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Zip | 92399-9630
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Country | US
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Telephone | 909-797-0114
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Fax |
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Provider Business Mailing Address
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Address Line | 10776 FREMONT ST
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City | YUCAIPA
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State | CA
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Zip | 92399-9630
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-19-103868
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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