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NPI Code Detail

MEDICARE: JORDAN MCGRAW-KILBURN BCBA

MEDICARE: JORDAN MCGRAW-KILBURN 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 Analyst1-21-50318CA

General Provider Information

NPI Number : 1891202453
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN MCGRAW-KILBURN BCBA
Provider Business Mailing Address
First Line : 768 N OLIVE ST
Second Line :
City : VENTURA
State : CA
Zip : 93001-1662
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 400 W VENTURA BLVD STE 230
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-9142
Country : US
Telephone Number : 858-264-5858
Fax Number : 858-649-6012
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2018
Last Update Date : 06/04/2021

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