Healthcare Provider Details

I. General information

NPI: 1477320869
Provider Name (Legal Business Name): ARABELLE BUSTOS - VAN RANZOW MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ARABELLE BUSTOS - VAN RANZOW

II. Dates (important events)

Enumeration Date: 12/06/2023
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 S MARENGO AVE APT 1
PASADENA CA
91106-3637
US

IV. Provider business mailing address

918 S MARENGO AVE APT 1
PASADENA CA
91106-3637
US

V. Phone/Fax

Practice location:
  • Phone: 323-219-0073
  • Fax:
Mailing address:
  • Phone: 323-219-0073
  • 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 Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: