Healthcare Provider Details

I. General information

NPI: 1003767815
Provider Name (Legal Business Name): BEHAVIORAL DYNAMICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 N HIGHLAND AVE STE A
LOS ANGELES CA
90028-4404
US

IV. Provider business mailing address

1776 N HIGHLAND AVE STE A
LOS ANGELES CA
90028-4404
US

V. Phone/Fax

Practice location:
  • Phone: 323-608-0401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRENT AIELLO
Title or Position: CEO
Credential:
Phone: 323-608-0401