Healthcare Provider Details

I. General information

NPI: 1891013736
Provider Name (Legal Business Name): APPLIED BEHAVIORAL LEARNING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2010
Last Update Date: 10/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

963 WEST AVENUE J
LANCASTER CA
93534
US

IV. Provider business mailing address

1407 FOOTHILL BLVD #78
LA VERNE CA
91750-3451
US

V. Phone/Fax

Practice location:
  • Phone: 661-224-9310
  • Fax: 800-516-1658
Mailing address:
  • Phone: 818-789-4540
  • Fax: 818-789-4541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LINDA J. YI
Title or Position: DIRECTOR
Credential: B.C.B.A.
Phone: 818-789-4540