=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457730459
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANSWERS TO BEHAVIORAL CHALLENGES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/22/2015
-----------------------------------------------------
Last Update Date | 05/22/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1734 N VERDUGO RD APT 12
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91208-2723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-980-3643
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1734 N VERDUGO RD APT 12
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91208-2723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-980-3643
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CLINICAL DIRECTOR
-----------------------------------------------------
Name | CARLA V DIRAN
-----------------------------------------------------
Credential | BCBA
-----------------------------------------------------
Telephone | 310-980-3643
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number | 1-12-10272
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------