Healthcare Provider Details

I. General information

NPI: 1417789199
Provider Name (Legal Business Name): FELICIA WESTCOTT BCAB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4740 GREEN RIVER RD STE 313
CORONA CA
92878-9437
US

IV. Provider business mailing address

1294 NORTHWEST DR NW
ATLANTA GA
30318-3845
US

V. Phone/Fax

Practice location:
  • Phone: 678-691-2206
  • Fax:
Mailing address:
  • Phone: 340-277-2145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: