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NPI Code Detail

MEDICARE: YAJAIRA HIDALGO CERVANTES BCBA

MEDICARE: YAJAIRA HIDALGO CERVANTES BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystCA

General Provider Information

NPI Number : 1073136669
Entity Type Code : Individual
Provider Name (Legal Business Name) : YAJAIRA HIDALGO CERVANTES BCBA
Provider Business Mailing Address
First Line : 21600 OXNARD ST
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-4976
Country : US
Telephone Number : 877-206-1009
Fax Number :
Provider Business Practice Location Address
First Line : 21600 OXNARD ST STE 200
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-4971
Country : US
Telephone Number : 877-206-1009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2020
Last Update Date : 12/05/2024

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