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General NPI Number Information
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NPI Number | 1760803209
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Entity Type | Organization
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Legal Business Name | ABAWORKS LLC.
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Dates
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Enumeration Date | 12/31/2013
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Last Update Date | 10/07/2015
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Provider Practice Location Address
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Address Line | 969 S VILLAGE OAKS DR STE 204
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City | COVINA
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State | CA
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Zip | 91724-0606
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Country | US
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Telephone | 909-621-0713
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Fax | 866-579-6146
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Provider Business Mailing Address
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Address Line | 969 S VILLAGE OAKS DR STE 204
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City | COVINA
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State | CA
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Zip | 91724-0606
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Country | US
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Telephone | 909-621-0713
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Fax | 866-579-6146
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. YESENIA RODRIGUEZ
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Credential | BCBA
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Telephone | 909-621-0713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1-11-9303
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1-11-8970
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License Number State | CA
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