Healthcare Provider Details
I. General information
NPI: 1043194756
Provider Name (Legal Business Name): DJED INSTITUTE OF LEARNING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1330 W 49TH ST
LOS ANGELES CA
90037
US
IV. Provider business mailing address
1330 W 49TH ST
LOS ANGELES CA
90037
US
V. Phone/Fax
- Phone: 909-576-0170
- Fax:
- Phone: 909-576-0170
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KENNETH
KAFELE
Title or Position: OWNER
Credential: BCBA
Phone: 909-576-0170