Provider Demographics
NPI:1629939558
Name:LITTLEJOHN, AMBER T (RBT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:T
Last Name:LITTLEJOHN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 SANTA VENETIA ST APT 17325
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-3685
Mailing Address - Country:US
Mailing Address - Phone:912-227-4337
Mailing Address - Fax:
Practice Address - Street 1:1177 BROADWAY STE 6-10
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-2769
Practice Address - Country:US
Practice Address - Phone:800-434-8923
Practice Address - Fax:858-649-6012
Is Sole Proprietor?:No
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-25-492651106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician