MEDICARE: RAFFI SARAFIAN 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
1	103K00000X	Behavior Analyst	1-17-28675	CA

General Provider Information

NPI Number	:	1124497755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAFFI SARAFIAN BCBA

Provider Business Mailing Address
First Line	:	4401 CRENSHAW BLVD STE 215
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90043-1200
Country	:	US
Telephone Number	:	323-291-7100
Fax Number	:

Provider Business Practice Location Address
First Line	:	4401 CRENSHAW BLVD STE 215
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90043-1200
Country	:	US
Telephone Number	:	323-291-7100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2015
Last Update Date	:	06/05/2026

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