Healthcare Provider Details

I. General information

NPI: 1194322701
Provider Name (Legal Business Name): STEPHANIE LUTHER CHANEY MS., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24630 WASHINGTON AVE STE 102
MURRIETA CA
92562-6177
US

IV. Provider business mailing address

24630 WASHINGTON AVE STE 102
MURRIETA CA
92562-6177
US

V. Phone/Fax

Practice location:
  • Phone: 310-940-6713
  • Fax:
Mailing address:
  • Phone: 310-940-6713
  • Fax: 206-415-0957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-43941
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: