Healthcare Provider Details

I. General information

NPI: 1932034584
Provider Name (Legal Business Name): PRIME FOCUS ABA SOLUTION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

10732 DE HAVEN AVE
PACOIMA CA
91331-2007
US

IV. Provider business mailing address

8605 SANTA MONICA BLVD
WEST HOLLYWOOD CA
90069-4109
US

V. Phone/Fax

Practice location:
  • Phone: 629-215-8914
  • Fax:
Mailing address:
  • Phone: 626-215-8914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JAZMIN INGRAM
Title or Position: OWNER/BCBA
Credential: BCBA
Phone: 629-215-8914