Healthcare Provider Details
I. General information
NPI: 1912838038
Provider Name (Legal Business Name): ATLAS ABA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17146 STARE ST
NORTHRIDGE CA
91325-1649
US
IV. Provider business mailing address
17146 STARE ST
NORTHRIDGE CA
91325-1649
US
V. Phone/Fax
- Phone: 818-770-5717
- Fax:
- Phone: 818-770-5717
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HOVHANNES
JACK
MAGDHZYAN
Title or Position: MANAGER OF LLC
Credential:
Phone: 818-770-5717