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General NPI Number Information
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NPI Number | 1174163323
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Entity Type | Organization
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Legal Business Name | KNOWLEDGE OF AUTISM & OTHER DEVELOPMENTAL DISABILITIES, LLC.
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Dates
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Enumeration Date | 01/15/2020
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Last Update Date | 01/21/2020
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Provider Practice Location Address
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Address Line | 890 WHITEBOOK DRIVE
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City | LA HABRA
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State | CA
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Zip | 90631
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Country | US
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Telephone | 562-458-0629
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Fax |
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Provider Business Mailing Address
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Address Line | 14742 BEACH BLVD # 442
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City | LA MIRADA
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State | CA
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Zip | 90638-4217
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | ALICIA IGARTA
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Credential | BCBA
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Telephone | 562-458-0629
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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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