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General NPI Number Information
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NPI Number | 1164130530
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Entity Type | Organization
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Legal Business Name | BEHAVIOR SPECIALIST SERVICES INC
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 5040 N JENIFER AVE
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City | COVINA
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State | CA
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Zip | 91724-1042
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Country | US
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Telephone | 323-712-1071
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Fax |
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Provider Business Mailing Address
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Address Line | 5040 N JENIFER AVE
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City | COVINA
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State | CA
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Zip | 91724-1042
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Country | US
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Telephone | 323-712-1071
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Fax |
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Authorized Official
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Title or Position | BEHAVIOR ANALYST
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Name | GILDA PANALES
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Credential | BCBA
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Telephone | 323-712-1071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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