Healthcare Provider Details

I. General information

NPI: 1588936074
Provider Name (Legal Business Name): KEY TO BEHAVIOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2012
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41760 IVY ST 101
MURRIETA CA
92562
US

IV. Provider business mailing address

41760 IVY ST 101
MURRIETA CA
92562
US

V. Phone/Fax

Practice location:
  • Phone: 951-595-4673
  • Fax: 951-595-4301
Mailing address:
  • Phone: 951-595-4673
  • Fax: 951-595-4301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1-09-6422
License Number StateTX

VIII. Authorized Official

Name: AMBER MALDONADO
Title or Position: DIRECTOR, CO-FOUNDER
Credential: MS, CCC-SLP
Phone: 951-595-4673