Healthcare Provider Details

I. General information

NPI: 1124277454
Provider Name (Legal Business Name): GABRIELLE IZRALSON PSYD, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2008
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2029 CENTURY PARK E STE 450
LOS ANGELES CA
90067-2926
US

IV. Provider business mailing address

2029 CENTURY PARK E STE 450
LOS ANGELES CA
90067-2926
US

V. Phone/Fax

Practice location:
  • Phone: 310-801-7821
  • Fax:
Mailing address:
  • Phone: 310-801-7821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-10-7720
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: