Healthcare Provider Details

I. General information

NPI: 1801665609
Provider Name (Legal Business Name): FELIPE JUAQUIN CAMPOS JR. BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16400 VENTURA BLVD STE 327
ENCINO CA
91436-2190
US

IV. Provider business mailing address

16400 VENTURA BLVD STE 327
ENCINO CA
91436-2190
US

V. Phone/Fax

Practice location:
  • Phone: 747-221-4222
  • Fax:
Mailing address:
  • Phone: 747-221-4222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-71838
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: