| Organization Name: | PASSPORT TO ADAPTIVE LIVING |
| NPI Number: | 1922452192 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEREMY WILSON (CLINICAL DIRECTOR) |
| Mailing Address: | 2291 Portola Road Unit A Ventura |
| State: | CA US |
| Postal Code: | 93003 |
| Phone Number: | 8053390210 |
| Fax Number: | |
| NPI Enumeration Date: | 04/14/2016 |
| NPI Last Update Date: | 04/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103K00000X |
| License Number: | 0-16-7052 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Behavioral Analyst |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A Behavior Analyst is a practitioner who specializes in analysis of behavior problems and development of appropriate intervention and treatment plans. A Behavior Analyst may work independently or with a team of professionals. Behavior Analysts often specialize in a particular area such as autism, developmental disabilities, mental health, geriatrics, or head trauma. |