Healthcare Provider Details

I. General information

NPI: 1043838220
Provider Name (Legal Business Name): ABA ETHICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2020
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15315 MAGNOLIA BLVD STE 428
SHERMAN OAKS CA
91403-1177
US

IV. Provider business mailing address

15315 MAGNOLIA BLVD STE 428
SHERMAN OAKS CA
91403-1177
US

V. Phone/Fax

Practice location:
  • Phone: 818-605-7451
  • Fax:
Mailing address:
  • Phone: 818-605-7451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AVISHAI ZACHARIA
Title or Position: DIRECTOR
Credential: M.A B.C.B.A
Phone: 818-605-7451