Healthcare Provider Details

I. General information

NPI: 1578829552
Provider Name (Legal Business Name): DENISE BESS ROCKWELL BCBA-D, PHD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 11/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 CAMPUS RD
LOS ANGELES CA
90042-1653
US

IV. Provider business mailing address

1555 CAMPUS RD
LOS ANGELES CA
90042-1653
US

V. Phone/Fax

Practice location:
  • Phone: 818-427-8300
  • Fax:
Mailing address:
  • Phone: 818-427-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY27727
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-11-8478
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: