Healthcare Provider Details

I. General information

NPI: 1578488268
Provider Name (Legal Business Name): DENISE KELLENER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5959 TOPANGA CANYON BLVD STE 125
WOODLAND HILLS CA
91367-7598
US

IV. Provider business mailing address

5851 SERRANIA AVE
WOODLAND HILLS CA
91367-6715
US

V. Phone/Fax

Practice location:
  • Phone: 469-694-1754
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: