Healthcare Provider Details

I. General information

NPI: 1205765666
Provider Name (Legal Business Name): VELVET & OAK BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

3472 E PARADUXX PRIVADO
ONTARIO CA
91762-7505
US

IV. Provider business mailing address

8605 SANTA MONICA BLVD # 546405
WEST HOLLYWOOD CA
90069-4109
US

V. Phone/Fax

Practice location:
  • Phone: 951-345-2335
  • Fax:
Mailing address:
  • Phone: 951-345-2335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CAROLINE ROBLES
Title or Position: BCBA, OWNER
Credential: MA, BCBA
Phone: 951-345-2335