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NPI Code Detail

MEDICARE: REBEKAH MALDONADO NONE

MEDICARE: REBEKAH MALDONADO NONE
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
1103K00000XBehavior Analyst1-26-88029CO

General Provider Information

NPI Number : 1366194979
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBEKAH MALDONADO NONE
Provider Business Mailing Address
First Line : 18726 S WESTERN AVE
Second Line :
City : GARDENA
State : CA
Zip : 90248-3813
Country : US
Telephone Number : 310-856-0800
Fax Number : 855-568-2494
Provider Business Practice Location Address
First Line : 4770 BASELINE RD STE 200
Second Line :
City : BOULDER
State : CO
Zip : 80303-2668
Country : US
Telephone Number : 970-982-3476
Fax Number : 855-568-2494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2022
Last Update Date : 03/04/2026

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