Healthcare Provider Details

I. General information

NPI: 1124908686
Provider Name (Legal Business Name): PROSOCIAL PATHWAYS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 E 90TH ST
LOS ANGELES CA
90002-1613
US

IV. Provider business mailing address

735 E 90TH ST
LOS ANGELES CA
90002-1613
US

V. Phone/Fax

Practice location:
  • Phone: 323-829-0343
  • Fax:
Mailing address:
  • Phone: 323-829-0343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: SANDY ZAMORA
Title or Position: BEHAVIOR ANALYST
Credential: BCBA
Phone: 323-829-0343