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General NPI Number Information
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NPI Number | 1225328867
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Entity Type | Individual
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Provider Name | BRIAN PATRICK MAHORNEY B.C.B.A.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2011
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Last Update Date | 09/13/2011
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Provider Practice Location Address
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Address Line | 9531 PITTSBURGH AVE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-6008
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Country | US
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Telephone | 909-484-2848
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Fax |
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Provider Business Mailing Address
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Address Line | 11990 SPRINGVIEW DR
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City | LA MIRADA
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State | CA
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Zip | 90638-1126
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Country | US
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Telephone | 562-762-0897
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1-09-5042
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License Number State | CA
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