MEDICARE: AARON KOAY MS, 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
1	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst	1-21-47250	CA

General Provider Information

NPI Number	:	1922630938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON KOAY MS, BCBA

Provider Business Mailing Address
First Line	:	21615 BROOKSIDE CT
Second Line	:
City	:	WALNUT
State	:	CA
Zip	:	91789-1413
Country	:	US
Telephone Number	:	909-569-5814
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 ELKINS PL
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-1518
Country	:	US
Telephone Number	:	909-569-5814
Fax Number	:

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

Provider Enumeration Date	:	02/07/2020
Last Update Date	:	04/10/2023

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