Healthcare Provider Details

I. General information

NPI: 1356164925
Provider Name (Legal Business Name): LITTLE STEPS PEDIATRIC THERAPIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12303 BLODGETT AVE
DOWNEY CA
90242-2601
US

IV. Provider business mailing address

12303 BLODGETT AVE
DOWNEY CA
90242-2601
US

V. Phone/Fax

Practice location:
  • Phone: 805-815-9048
  • Fax:
Mailing address:
  • Phone: 805-815-9048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MR. JAVIER MURILLO JR.
Title or Position: CEO
Credential: M.S., BCBA
Phone: 805-815-9048