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General NPI Number Information
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NPI Number | 1467036038
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Entity Type | Individual
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Provider Name | RACHEL LAYN MOKLER BCBA
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Gender | Female
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Dates
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Enumeration Date | 05/10/2021
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 1200 CONCORD AVE STE 100
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City | CONCORD
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State | CA
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Zip | 94520-4969
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Country | US
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Telephone | 510-268-8120
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Fax |
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Provider Business Mailing Address
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Address Line | 9114 WAKEFIELD AVE
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City | PANORAMA CITY
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State | CA
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Zip | 91402
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Country | US
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Telephone | 702-339-6895
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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 | 1-21-49704
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License Number State | CA
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