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General NPI Number Information
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NPI Number | 1487049755
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Entity Type | Individual
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Provider Name | EMILY INGRAM
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Gender | Female
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 877 YGNACIO VALLEY RD STE 100
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City | WALNUT CREEK
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State | CA
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Zip | 94596-3897
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Country | US
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Telephone | 925-482-3330
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Fax | 925-482-3333
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Provider Business Mailing Address
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Address Line | 119 W TORRANCE BLVD
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City | REDONDO BEACH
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State | CA
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Zip | 90277-3600
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Country | US
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Telephone | 310-374-3300
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Fax | 310-374-3307
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-15-18248
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License Number State | CA
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