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NPI Code Detail

MEDICARE: THOMAS JOSEPH VANMARTER BCBA

MEDICARE: THOMAS JOSEPH VANMARTER 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 Analyst1-16-22082CA

General Provider Information

NPI Number : 1679937320
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS JOSEPH VANMARTER BCBA
Provider Business Mailing Address
First Line : 1230 ROSECRANS AVE STE 250
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-2496
Country : US
Telephone Number : 310-406-1500
Fax Number :
Provider Business Practice Location Address
First Line : 1230 ROSECRANS AVE STE 250
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-2496
Country : US
Telephone Number : 310-406-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2016
Last Update Date : 04/08/2016

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Directions to “ THOMAS JOSEPH VANMARTER BCBA” Practice Location

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