Healthcare Provider Details

I. General information

NPI: 1225542103
Provider Name (Legal Business Name): ABACADABRA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2017
Last Update Date: 05/04/2025
Certification Date: 05/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7840 FOOTHILL BLVD STE H
SUNLAND CA
91040-2907
US

IV. Provider business mailing address

7840 FOOTHILL BLVD STE H
SUNLAND CA
91040-2907
US

V. Phone/Fax

Practice location:
  • Phone: 818-273-9802
  • Fax: 855-743-1238
Mailing address:
  • Phone: 818-273-9802
  • Fax: 855-743-1238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: CAROL CASTELLON
Title or Position: CLINICAL DIRECTOR
Credential: BCBA
Phone: 310-227-7384