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General NPI Number Information
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NPI Number | 1720784382
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Entity Type | Individual
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Provider Name | KRISTA KASSIN BCABA
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Gender | Female
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 1968 W ADAMS BLVD STE 105
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City | LOS ANGELES
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State | CA
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Zip | 90018-3515
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Country | US
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Telephone | 310-553-2695
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Fax |
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Provider Business Mailing Address
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Address Line | 614 N PARK AVE
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-2365
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Country | US
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Telephone | 586-842-7972
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State | MI
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