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General NPI Number Information
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NPI Number | 1487363271
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Entity Type | Organization
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Legal Business Name | ASCENT ABA
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Dates
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Enumeration Date | 11/21/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 9887 SUMMERHILL RD
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91737-1677
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Country | US
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Telephone | 909-579-2524
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Fax |
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Provider Business Mailing Address
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Address Line | 6649 AMETHYST AVE UNIT 9321
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-1557
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JONATHAN CARRILLO
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Credential | BCBA
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Telephone | 559-975-9418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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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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