Healthcare Provider Details
I. General information
NPI: 1326899188
Provider Name (Legal Business Name): OHANA BEHAVIORAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/29/2024
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9901 PARAMOUNT BLVD STE 222
DOWNEY CA
90240-3853
US
IV. Provider business mailing address
9901 PARAMOUNT BLVD STE 222
DOWNEY CA
90240-3853
US
V. Phone/Fax
- Phone: 562-454-7998
- Fax: 562-222-3054
- Phone: 562-299-4759
- Fax: 562-222-3054
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANGELICA
GONZALES
Title or Position: CEO
Credential: PSYD, BCBA
Phone: 562-299-4759