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NPI Code Detail

MEDICARE: JOHN THOMAS JUSTIN GUNTON-BELL BA

MEDICARE: JOHN THOMAS JUSTIN GUNTON-BELL BA
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
1106E00000XAssistant Behavior AnalystCA

General Provider Information

NPI Number : 1104317403
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN THOMAS JUSTIN GUNTON-BELL BA
Provider Business Mailing Address
First Line : 8801 FOLSOM BLVD STE 195
Second Line :
City : SACRAMENTO
State : CA
Zip : 95826-3231
Country : US
Telephone Number : 916-382-4447
Fax Number :
Provider Business Practice Location Address
First Line : 8801 FOLSOM BLVD STE 195
Second Line :
City : SACRAMENTO
State : CA
Zip : 95826-3231
Country : US
Telephone Number : 916-382-4447
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2018
Last Update Date : 05/22/2018

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