Healthcare Provider Details

I. General information

NPI: 1851997043
Provider Name (Legal Business Name): HANNAH JOSIE SANDOVAL BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2020
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2955 CAMINO CALANDRIA
THOUSAND OAKS CA
91360-4532
US

IV. Provider business mailing address

2955 CAMINO CALANDRIA
THOUSAND OAKS CA
91360-4532
US

V. Phone/Fax

Practice location:
  • Phone: 805-870-9600
  • Fax: 805-870-8159
Mailing address:
  • Phone: 805-870-9600
  • Fax: 805-870-8159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-67925
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: