Healthcare Provider Details

I. General information

NPI: 1659995918
Provider Name (Legal Business Name): COMPASSIONATE ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2020
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11303 ELMCROFT AVE
NORWALK CA
90650-7610
US

IV. Provider business mailing address

11303 ELMCROFT AVE
NORWALK CA
90650-7610
US

V. Phone/Fax

Practice location:
  • Phone: 562-239-9902
  • Fax: 562-376-3646
Mailing address:
  • Phone: 562-239-9902
  • Fax: 562-376-3646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: FERNANDO W MARTINEZ JR.
Title or Position: CEO
Credential: BCBA, LBA
Phone: 562-239-9902