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General NPI Number Information
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NPI Number | 1366230542
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Entity Type | Organization
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Legal Business Name | PACIFIC BEHAVIORAL SERVICES LLC
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Dates
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Enumeration Date | 04/28/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 6120 SUTTER ST
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City | VENTURA
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State | CA
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Zip | 93003-2431
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Country | US
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Telephone | 949-751-7233
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Fax |
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Provider Business Mailing Address
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Address Line | 6120 SUTTER ST
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City | VENTURA
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State | CA
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Zip | 93003-2431
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Country | US
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Telephone | 949-751-7233
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Fax |
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Authorized Official
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Title or Position | OWNER/BCBA
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Name | BENJAMIN ALAN INGALLS
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Credential | BCBA
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Telephone | 949-751-7233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 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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