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NPI Code Detail

MEDICARE: ELLA SARGENT MA, BCBA

MEDICARE: ELLA SARGENT MA, 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 Analyst1-13-14580CA

General Provider Information

NPI Number : 1073925145
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLA SARGENT MA, BCBA
Provider Business Mailing Address
First Line : 2555 3RD ST
Second Line : SUITE 210
City : SACRAMENTO
State : CA
Zip : 95818-1100
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2555 3RD ST
Second Line : SUITE 210
City : SACRAMENTO
State : CA
Zip : 95818-1100
Country : US
Telephone Number : 916-443-2479
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2014
Last Update Date : 05/23/2014

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Directions to “ ELLA SARGENT MA, BCBA” Practice Location

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