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General NPI Number Information
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NPI Number | 1194503631
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Entity Type | Organization
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Legal Business Name | WEST COAST ABA
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Dates
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Enumeration Date | 09/18/2023
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 8526 HICKORY LN
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City | RIVERSIDE
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State | CA
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Zip | 92504-2915
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Country | US
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Telephone | 714-319-5695
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Fax |
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Provider Business Mailing Address
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Address Line | 27945 GREENSPOT RD # 1035
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City | HIGHLAND
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State | CA
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Zip | 92346-4440
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Country | US
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Telephone | 714-319-5695
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE CLINICAL DIRECTOR
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Name | LLOYD MICHAEL GILBERT
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Credential | BCBA, LBA
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Telephone | 951-313-7203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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