MEDICARE: CEPHAS POPE

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	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1538902408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CEPHAS POPE

Provider Business Mailing Address
First Line	:	8018 S NEW HAMPSHIRE AVE # 2
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90044-3560
Country	:	US
Telephone Number	:	310-365-9630
Fax Number	:

Provider Business Practice Location Address
First Line	:	8018 S NEW HAMPSHIRE AVE # 2
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90044-3560
Country	:	US
Telephone Number	:	310-365-9630
Fax Number	:

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

Provider Enumeration Date	:	06/17/2024
Last Update Date	:	06/17/2024

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Directions to “ CEPHAS POPE ” Practice Location

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