Provider Demographics
NPI:1891202453
Name:MCGRAW-KILBURN, JORDAN (BCBA)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:MCGRAW-KILBURN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:
Other - Last Name:RYLANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:768 N OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-1662
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 W VENTURA BLVD STE 230
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-9142
Practice Address - Country:US
Practice Address - Phone:858-264-5858
Practice Address - Fax:858-649-6012
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-21-50318103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst