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General NPI Number Information
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NPI Number | 1891591798
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Entity Type | Organization
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Legal Business Name | INCLUSIVE AND EXTENSIVE AUTISM SERVICES
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 14500 ROSCOE BLVD. 4TH FLOOR
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City | PANORAMA CITY
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State | CA
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Zip | 91402
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Country | US
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Telephone | 661-741-2561
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Fax | 800-852-3387
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Provider Business Mailing Address
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Address Line | 22611 BARBACOA DR
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City | SANTA CLARITA
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State | CA
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Zip | 91350-2235
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Country | US
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Telephone | 661-247-3174
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Fax |
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Authorized Official
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Title or Position | OPERATIONS DIRECTOR
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Name | ANA MUNOZ
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Credential | MA
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Telephone | 661-247-3174
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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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