Healthcare Provider Details

I. General information

NPI: 1427981554
Provider Name (Legal Business Name): GREEN SUNFLOWER ABA THERAPY ILLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14901 NORFOLK CIR
MORENO VALLEY CA
92555-7064
US

IV. Provider business mailing address

14901 NORFOLK CIR
MORENO VALLEY CA
92555-7064
US

V. Phone/Fax

Practice location:
  • Phone: 909-329-4141
  • Fax:
Mailing address:
  • Phone: 909-329-4141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: KENIA CITLALY MUNOZ RIVERA
Title or Position: CEO
Credential:
Phone: 909-329-4141