Healthcare Provider Details

I. General information

NPI: 1477465144
Provider Name (Legal Business Name): LADY BALLAN DESOLIDAD BCBA BEHAVIOR ANALYS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S. BRIGHTON STREET.
BURBANK CA
91506
US

IV. Provider business mailing address

201 S. BRIGHTON STREET.
BURBANK CA
91506
US

V. Phone/Fax

Practice location:
  • Phone: 818-468-8841
  • Fax:
Mailing address:
  • Phone: 818-468-8841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: