Healthcare Provider Details

I. General information

NPI: 1285100198
Provider Name (Legal Business Name): KYLE AGUIRRE BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2018
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 S LA CIENEGA BLVD STE 306
LOS ANGELES CA
90035-2679
US

IV. Provider business mailing address

1080 S LA CIENEGA BLVD STE 306
LOS ANGELES CA
90035-2679
US

V. Phone/Fax

Practice location:
  • Phone: 310-402-3116
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: