MEDICARE: ABA EDUCATION FOUNDATION

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1720480320
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABA EDUCATION FOUNDATION

Provider Business Mailing Address
First Line	:	5694 MISSION CENTER RD
Second Line	:	SUITE 602, PMB 341
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4355
Country	:	US
Telephone Number	:	619-952-6295
Fax Number	:	619-220-0215

Provider Business Practice Location Address
First Line	:	7860 MISSION CENTER CT
Second Line	:	SUITE 100
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1329
Country	:	US
Telephone Number	:	619-952-6295
Fax Number	:	619-220-0215

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ERIN ZWAHLEN
Credential	:	PHD, BCBA-D
Telephone Number	:	619-952-6295

Provider Enumeration Date	:	09/25/2014
Last Update Date	:	09/25/2014

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Directions to “ABA EDUCATION FOUNDATION ” Practice Location

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