MEDICARE: FRANCESCA BALDASSANO BCABA 0-15-6507

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	0-15-6507	CA

General Provider Information

NPI Number	:	1295113512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCESCA BALDASSANO BCABA 0-15-6507

Provider Business Mailing Address
First Line	:	3424 MOTOR AVE STE 101
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-4710
Country	:	US
Telephone Number	:	424-672-6700
Fax Number	:

Provider Business Practice Location Address
First Line	:	3424 MOTOR AVE STE 101
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-4710
Country	:	US
Telephone Number	:	424-672-6700
Fax Number	:

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

Provider Enumeration Date	:	05/07/2015
Last Update Date	:	05/07/2015

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