Healthcare Provider Details
I. General information
NPI: 1407617004
Provider Name (Legal Business Name): KINDERREADY BEHAVIOR SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/19/2024
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
721 N VULCAN AVE STE 209
ENCINITAS CA
92024-2191
US
IV. Provider business mailing address
15208 AMSO ST
POWAY CA
92064-2606
US
V. Phone/Fax
- Phone: 414-520-8141
- Fax:
- Phone: 414-520-8141
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EGLAL
IBRAHIM
Title or Position: FOUNDER
Credential: BCBA
Phone: 414-520-8141