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General NPI Number Information
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NPI Number | 1073101374
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Entity Type | Organization
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Legal Business Name | PARAGON ABA LLC
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 6001 RIVERSIDE BLVD APT 203
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City | SACRAMENTO
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State | CA
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Zip | 95831-1330
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Country | US
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Telephone | 661-333-1981
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 221433
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City | SACRAMENTO
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State | CA
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Zip | 95822-8433
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Country | US
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Telephone | 661-333-1981
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ANTONIO PENUELAS
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Credential | BCBA
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Telephone | 661-333-1981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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