Healthcare Provider Details

I. General information

NPI: 1982979787
Provider Name (Legal Business Name): SENNY SCHNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2012
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6360 WILSHIRE BLVD STE 300
LOS ANGELES CA
90048-5603
US

IV. Provider business mailing address

18340 COLLINS ST UNIT C
TARZANA CA
91356-2474
US

V. Phone/Fax

Practice location:
  • Phone: 323-866-1880
  • Fax: 323-866-1881
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-12-10385
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: