Healthcare Provider Details
I. General information
NPI: 1861082109
Provider Name (Legal Business Name): AURORA BEHAVIORAL CONSULTANTS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/20/2021
Last Update Date: 01/20/2021
Certification Date: 01/20/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
342 ORANGE AVE
LONG BEACH CA
90802-3538
US
IV. Provider business mailing address
13 MISSION PLAZA DR
VENTURA CA
93001-2672
US
V. Phone/Fax
- Phone: 562-380-0754
- Fax:
- Phone: 562-380-0754
- 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
JOY
SMITH
Title or Position: EXECUTIVE DIRECTOR
Credential: BCBA
Phone: 907-862-7776