Healthcare Provider Details
I. General information
NPI: 1871460535
Provider Name (Legal Business Name): FUNCTIONAL BEHAVIORAL INTERVENTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2025
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2501 W LA HABRA BLVD STE 9
LA HABRA CA
90631-4354
US
IV. Provider business mailing address
2501 W LA HABRA BLVD STE 9
LA HABRA CA
90631-4354
US
V. Phone/Fax
- Phone: 562-298-0565
- Fax:
- Phone:
- 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:
STEVE
PEREZ
Title or Position: DIRECTOR
Credential:
Phone: 562-686-0512