Healthcare Provider Details
I. General information
NPI: 1861292336
Provider Name (Legal Business Name): ROADMAP ABA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2025
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17 ESTERNAY DR
FOOTHILL RANCH CA
92610-1929
US
IV. Provider business mailing address
17 ESTERNAY DR
FOOTHILL RANCH CA
92610-1929
US
V. Phone/Fax
- Phone: 949-500-9826
- Fax:
- Phone: 949-500-9826
- 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:
KATHLEEN
MARIE
ESCH
Title or Position: CEO
Credential: B.C.B.A.
Phone: 949-500-9826