Healthcare Provider Details

I. General information

NPI: 1659877298
Provider Name (Legal Business Name): APPLIED BEHAVIORAL ALTERNATIVES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 ELKINS PL
ARCADIA CA
91006-1518
US

IV. Provider business mailing address

2001 ELKINS PL
ARCADIA CA
91006-1518
US

V. Phone/Fax

Practice location:
  • Phone: 818-472-0646
  • Fax:
Mailing address:
  • Phone: 818-472-0646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DARREN C LEMON
Title or Position: PRESIDENT
Credential:
Phone: 818-472-0646