MEDICARE: KIMBERLY FELIX LANDIS RBT

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1184277915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY FELIX LANDIS RBT

Provider Business Mailing Address
First Line	:	5000 ONTEORA WAY
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1826
Country	:	US
Telephone Number	:	323-423-4181
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 E FOOTHILL BLVD STE 100
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-3443
Country	:	US
Telephone Number	:	323-423-4181
Fax Number	:

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

Provider Enumeration Date	:	07/21/2019
Last Update Date	:	07/21/2019

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Directions to “ KIMBERLY FELIX LANDIS RBT” Practice Location

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