Healthcare Provider Details

I. General information

NPI: 1790288728
Provider Name (Legal Business Name): SOHEYLA TORABI BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2018
Last Update Date: 01/06/2024
Certification Date: 01/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23612 VIA ESTELLA
MISSION VIEJO CA
92691-3508
US

IV. Provider business mailing address

23612 VIA ESTELLA
MISSION VIEJO CA
92691-3508
US

V. Phone/Fax

Practice location:
  • Phone: 909-485-2126
  • Fax:
Mailing address:
  • Phone: 909-485-2126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-70236
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: