Healthcare Provider Details

I. General information

NPI: 1366078164
Provider Name (Legal Business Name): ANNIKA MANLIGUEZ BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3424 MOTOR AVE STE 101
LOS ANGELES CA
90034-4710
US

IV. Provider business mailing address

11535 ROCHESTER AVE UNIT 102
LOS ANGELES CA
90025-7813
US

V. Phone/Fax

Practice location:
  • Phone: 424-672-6716
  • Fax:
Mailing address:
  • Phone: 714-397-3278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: