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General NPI Number Information
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NPI Number | 1982083218
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Entity Type | Individual
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Provider Name | SUAN MELISSA ILAGAN MONCAYO M.S., BCBA
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Gender | Female
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Dates
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Enumeration Date | 05/19/2015
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 145 S. FAIRFAX AVE. FLOOR 2
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City | LOS ANGELES
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State | CA
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Zip | 90036-2166
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Country | US
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Telephone | 855-832-6727
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Fax | 772-675-9100
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Provider Business Mailing Address
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Address Line | 3500 W MANCHESTER BLVD UNIT 63
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City | INGLEWOOD
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State | CA
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Zip | 90305-4063
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Country | US
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Telephone | 310-561-5745
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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 | 1-14-17807
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License Number State | CA
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