Healthcare Provider Details

I. General information

NPI: 1285598862
Provider Name (Legal Business Name): RISE & THRIVE GROWTH LAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 HOOPER AVE
SIMI VALLEY CA
93065-7360
US

IV. Provider business mailing address

619 HOOPER AVE
SIMI VALLEY CA
93065-7360
US

V. Phone/Fax

Practice location:
  • Phone: 818-919-0032
  • Fax:
Mailing address:
  • Phone: 818-919-0032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRITTNEY MICHAELS
Title or Position: OWNER/CEO
Credential: M.S., BCBA,
Phone: 818-919-0032