Healthcare Provider Details

I. General information

NPI: 1992582084
Provider Name (Legal Business Name): MOTIFA BEHAVIORAL CARE AND HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2023
Last Update Date: 09/12/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 NUECES LN
SPRING VALLEY CA
91977-7126
US

IV. Provider business mailing address

2309 NUECES LN
SPRING VALLEY CA
91977-7126
US

V. Phone/Fax

Practice location:
  • Phone: 619-396-8059
  • Fax:
Mailing address:
  • Phone: 619-396-8059
  • 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 Code171R00000X
TaxonomyInterpreter
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANN JAHOLA
Title or Position: BEHAVIOR ANALYST
Credential: M.S., BCBA
Phone: 619-396-8059