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General NPI Number Information
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NPI Number | 1891114534
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Entity Type | Individual
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Provider Name | MANUELA O POWERS BCBA
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Gender | Female
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 18002 IRVINE BLVD STE 202C
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City | TUSTIN
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State | CA
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Zip | 92780-3322
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Country | US
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Telephone | 949-231-7979
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Fax | 714-242-1646
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Provider Business Mailing Address
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Address Line | 18002 IRVINE BLVD STE 202C
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City | TUSTIN
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State | CA
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Zip | 92780-3322
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Country | US
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Telephone | 657-223-3986
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Fax | 714-242-1646
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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 | 1-14-5779
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License Number State | CA
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