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NPI Code Detail

MEDICARE: KAYLEIGH MATTOS BCBA

MEDICARE: KAYLEIGH MATTOS 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
1103K00000XBehavior Analyst11519851CO

General Provider Information

NPI Number : 1518210160
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLEIGH MATTOS BCBA
Provider Business Mailing Address
First Line : 4221 WILSHIRE BLVD STE 300A
Second Line :
City : LOS ANGELES
State : CA
Zip : 90010-3537
Country : US
Telephone Number : 888-428-3223
Fax Number : 323-866-1881
Provider Business Practice Location Address
First Line : 7200 S ALTON WAY STE A100
Second Line :
City : CENTENNIAL
State : CO
Zip : 80112-2207
Country : US
Telephone Number : 904-508-4034
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2012
Last Update Date : 09/08/2025

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Directions to “ KAYLEIGH MATTOS BCBA” Practice Location

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