Healthcare Provider Details

I. General information

NPI: 1629619705
Provider Name (Legal Business Name): AURA BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2019
Last Update Date: 06/16/2024
Certification Date: 06/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 ETHAN WAY STE 200
SACRAMENTO CA
95825-2277
US

IV. Provider business mailing address

1300 ETHAN WAY STE 200
SACRAMENTO CA
95825-2277
US

V. Phone/Fax

Practice location:
  • Phone: 888-744-2872
  • Fax: 916-800-3356
Mailing address:
  • Phone: 888-744-2872
  • Fax: 916-800-3356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MANUEL TER-POGOSYAN
Title or Position: CEO & FOUNDER
Credential: M.ED., BCBA
Phone: 888-744-2872