Healthcare Provider Details

I. General information

NPI: 1821962945
Provider Name (Legal Business Name): MELANIE MORGAN KOZAR RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 WILSHIRE BLVD STE 1400
LOS ANGELES CA
90010-1923
US

IV. Provider business mailing address

3435 WILSHIRE BLVD STE 1400
LOS ANGELES CA
90010-1923
US

V. Phone/Fax

Practice location:
  • Phone: 213-808-4149
  • Fax: 213-283-0572
Mailing address:
  • Phone: 213-808-4149
  • Fax: 213-283-0572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-440067
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: