Healthcare Provider Details

I. General information

NPI: 1750297800
Provider Name (Legal Business Name): FAITHWALKS ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6757 S HOLT AVE
LOS ANGELES CA
90056-2213
US

IV. Provider business mailing address

2108 N ST STE N
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 323-413-7139
  • Fax:
Mailing address:
  • Phone: 323-413-7139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TRISHA JANINE MCQUINN
Title or Position: OWNER/MEMBER
Credential:
Phone: 323-413-7139