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General NPI Number Information
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NPI Number | 1639589476
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Entity Type | Individual
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Provider Name | ALYSSA WARD BCBA
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Gender | Female
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Dates
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Enumeration Date | 05/02/2014
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Last Update Date | 01/01/2020
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Provider Practice Location Address
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Address Line | 400 W VENTURA BLVD STE 230
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City | CAMARILLO
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State | CA
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Zip | 93010-9142
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Country | US
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Telephone | 805-264-5858
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Fax |
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Provider Business Mailing Address
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Address Line | 127 GLEN ELLEN DR
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City | VENTURA
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State | CA
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Zip | 93003-3113
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Country | US
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Telephone | 805-501-8976
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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 | 0-13-5565
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License Number State | CA
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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 | 1-19-40094
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License Number State | CA
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