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General NPI Number Information
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NPI Number | 1780458570
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Entity Type | Organization
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Legal Business Name | STRIVE ABC A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 1420 N CLAREMONT BLVD STE 102B
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City | CLAREMONT
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State | CA
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Zip | 91711-3583
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Country | US
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Telephone | 626-209-9042
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Fax |
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Provider Business Mailing Address
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Address Line | 1420 N CLAREMONT BLVD STE 102B
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City | CLAREMONT
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State | CA
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Zip | 91711-3583
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Country | US
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Telephone | 626-209-9042
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JESSICA MARIE LASCANO
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Credential | BCBA
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Telephone | 626-209-9042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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