Wilson, Jeremy

Wilson, Jeremy is an individual health care provider with primary practice located at 1673 Donlon St Ste 204 , Ventura CA 93003-5668. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Wilson, Jeremy can be contacted via phone (805) 339-0210.

Contact Information

Primary practice address
1673 Donlon St Ste 204 Ventura CA 93003-5668
Phone: (805) 339-0210
Fax: (805) 642-3757
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-11-7960 California

Profile Details

NPI number 1821357716
LBN Legal business name Wilson, Jeremy
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2012
Last updated May 11th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821357716 NPPES
California Other 1-11-7960 BCBA CERTIFICATE

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