Healthcare Provider Details

I. General information

NPI: 1639601701
Provider Name (Legal Business Name): NINA NATHAN ALLEN M.A., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CORPORATE CENTER DR STE 120&130
MONTEREY PARK CA
91754-7600
US

IV. Provider business mailing address

7001 W PARKER RD APT 324
PLANO TX
75093-8616
US

V. Phone/Fax

Practice location:
  • Phone: 408-260-5003
  • Fax: 408-260-5003
Mailing address:
  • Phone: 940-465-3619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1458
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-17-25123
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: