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NPI Code Detail

MEDICARE: DR. JOHN LUBBERS BCBA

MEDICARE: DR. JOHN LUBBERS BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-01-0404CA

General Provider Information

NPI Number : 1063647550
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN LUBBERS BCBA
Provider Business Mailing Address
First Line : 7149 WOODLEY AVE
Second Line :
City : VAN NUYS
State : CA
Zip : 91406-3932
Country : US
Telephone Number : 818-442-0921
Fax Number : 800-832-2321
Provider Business Practice Location Address
First Line : 7149 WOODLEY AVE
Second Line :
City : VAN NUYS
State : CA
Zip : 91406-3932
Country : US
Telephone Number : 818-442-0921
Fax Number : 800-832-2321
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2009
Last Update Date : 05/27/2009

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