Healthcare Provider Details

I. General information

NPI: 1003251711
Provider Name (Legal Business Name): KEVIN HO BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1969 STRATHMORE AVE
SAN GABRIEL CA
91776-4240
US

IV. Provider business mailing address

1969 STRATHMORE AVE
SAN GABRIEL CA
91776-4240
US

V. Phone/Fax

Practice location:
  • Phone: 213-820-4726
  • Fax:
Mailing address:
  • Phone: 213-820-4726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-11-9013
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: