MEDICARE: JAMIE ALTOON

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1376320416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE ALTOON

Provider Business Mailing Address
First Line	:	1 UNIVERSITY DR # H103
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012-8599
Country	:	US
Telephone Number	:	818-472-1122
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 UNIVERSITY DR # H103
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012-8599
Country	:	US
Telephone Number	:	818-472-1122
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2023
Last Update Date	:	09/12/2023

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Directions to “ JAMIE ALTOON ” Practice Location

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