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General NPI Number Information
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NPI Number | 1508451204
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Entity Type | Individual
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Provider Name | SAMUEL ALEXANDER NASSAB MS
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Gender | Male
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 2101 N GLENOAKS BLVD
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City | BURBANK
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State | CA
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Zip | 91504-2828
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Country | US
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Telephone | 213-342-5706
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Fax | 818-848-8886
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Provider Business Mailing Address
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Address Line | 2101 N GLENOAKS BLVD
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City | BURBANK
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State | CA
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Zip | 91504-2828
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Country | US
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Telephone | 213-342-5706
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Fax | 818-848-8886
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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 |
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License Number State |
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