Healthcare Provider Details

I. General information

NPI: 1457067654
Provider Name (Legal Business Name): AMADA ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2023
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12215 TELEGRAPH RD STE 210A
SANTA FE SPRINGS CA
90670-3344
US

IV. Provider business mailing address

12215 TELEGRAPH RD STE 210A
SANTA FE SPRINGS CA
90670-3344
US

V. Phone/Fax

Practice location:
  • Phone: 626-268-1624
  • Fax: 626-268-8895
Mailing address:
  • Phone: 626-873-0560
  • Fax: 626-612-8895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE MALDONADO
Title or Position: OWNER
Credential: M.S. BCBA
Phone: 626-873-0560