Healthcare Provider Details

I. General information

NPI: 1396688412
Provider Name (Legal Business Name): KINDROOTS ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10766 BROOKWELL DR
CUPERTINO CA
95014-4609
US

IV. Provider business mailing address

10766 BROOKWELL DR
CUPERTINO CA
95014-4609
US

V. Phone/Fax

Practice location:
  • Phone: 786-399-2651
  • Fax:
Mailing address:
  • Phone: 786-399-2651
  • 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: ANAIBY L GARCIA
Title or Position: BCBA
Credential: MS
Phone: 786-399-2651