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General NPI Number Information
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NPI Number | 1760022529
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Entity Type | Individual
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Provider Name | ALISHA NYKIA SEABROOKS MA, BCBA
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Gender | Female
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Dates
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Enumeration Date | 01/09/2020
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 5005 CANYON CREST DR
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City | RIVERSIDE
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State | CA
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Zip | 92507-7721
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Country | US
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Telephone | 951-346-4860
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Fax |
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Provider Business Mailing Address
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Address Line | 25563 ESTRELLAS LN
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City | MORENO VALLEY
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State | CA
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Zip | 92551-7037
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Country | US
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Telephone | 760-277-0552
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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 | 1-19-39244
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License Number State | CA
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