Healthcare Provider Details

I. General information

NPI: 1063269959
Provider Name (Legal Business Name): PYLES & ASSOCIATES ABA PSYCHOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 04/30/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 GLENVIA ST STE 200
GLENDALE CA
91206-2427
US

IV. Provider business mailing address

741 GLENVIA ST STE 200
GLENDALE CA
91206-2427
US

V. Phone/Fax

Practice location:
  • Phone: 833-968-7762
  • Fax: 213-402-8600
Mailing address:
  • Phone: 833-968-7762
  • Fax: 213-402-8600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: DAVID PYLES
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 833-968-7762