MEDICARE: NOGA KLAIN BCBA

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1275887762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOGA KLAIN BCBA

Provider Business Mailing Address
First Line	:	416 SAN VICENTE BLVD APT 103
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90402-1710
Country	:	US
Telephone Number	:	310-692-4229
Fax Number	:

Provider Business Practice Location Address
First Line	:	416 SAN VICENTE BLVD APT 103
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90402-1710
Country	:	US
Telephone Number	:	310-692-4229
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2012
Last Update Date	:	11/20/2013

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Directions to “ NOGA KLAIN BCBA” Practice Location

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