Healthcare Provider Details
I. General information
NPI: 1972995959
Provider Name (Legal Business Name): NOVO BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2015
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1720 W BALL RD STE 4A
ANAHEIM CA
92804-5589
US
IV. Provider business mailing address
1720 W BALL RD STE 4A
ANAHEIM CA
92804-5589
US
V. Phone/Fax
- Phone: 714-257-5534
- Fax: 714-386-7019
- Phone: 714-257-5534
- Fax: 714-386-7019
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAVIER
MURILLO
JR.
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.S., BCBA
Phone: 805-815-9048