Healthcare Provider Details

I. General information

NPI: 1326503863
Provider Name (Legal Business Name): MYRON MALATA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4880 MARKET STREET, VENTURA, CA 93003
VENTURA CA
93003
US

IV. Provider business mailing address

4880 MARKET ST., VENTURA, CA 93003
VENTURA CA
93003
US

V. Phone/Fax

Practice location:
  • Phone: 805-364-8521
  • Fax:
Mailing address:
  • Phone: 805-364-8521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: