NPI 1356033005

Justin Ace Nilson

Practitioner Developmental Therapist Encino, CA

Practice location

Address: 16500 Ventura Blvd STE 414, Encino, CA 91436-5050
Phone: (818) 788-1003

Registered specialties (2)

Developmental Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Q00000X

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Behavior Technician

Behavioral Health & Social Service Providers Taxonomy 106S00000X Licence 106S00000X (CA)

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Registry record

NPI: 1356033005
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 May 2023
Record last updated: 24 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.