Healthcare Provider Details

I. General information

NPI: 1568846285
Provider Name (Legal Business Name): YULIZA MEJIA-TOBAR BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2015
Last Update Date: 07/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 N HOLLYWOOD WAY STE 102
BURBANK CA
91505-5031
US

IV. Provider business mailing address

2550 N HOLLYWOOD WAY STE 102
BURBANK CA
91505-5031
US

V. Phone/Fax

Practice location:
  • Phone: 866-727-8274
  • Fax:
Mailing address:
  • Phone: 866-727-8274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-16855
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: