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NPI Code Detail

MEDICARE: ASHLEY SAMANTHA ACOSTA

MEDICARE: ASHLEY SAMANTHA ACOSTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1225970767
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY SAMANTHA ACOSTA
Provider Business Mailing Address
First Line : 4401 CRENSHAW BLVD STE 215
Second Line :
City : LOS ANGELES
State : CA
Zip : 90043-1200
Country : US
Telephone Number : 323-291-7100
Fax Number :
Provider Business Practice Location Address
First Line : 4401 CRENSHAW BLVD STE 215
Second Line :
City : LOS ANGELES
State : CA
Zip : 90043-1200
Country : US
Telephone Number : 323-291-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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Directions to “ ASHLEY SAMANTHA ACOSTA ” Practice Location

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