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NPI Code Detail

MEDICARE: ASOR PENA

MEDICARE: ASOR PENA
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
1106S00000XBehavior Technician
2106E00000XAssistant Behavior Analyst

General Provider Information

NPI Number : 1245819838
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASOR PENA
Provider Business Mailing Address
First Line : 18860 NORDHOFF ST STE 100
Second Line :
City : NORTHRIDGE
State : CA
Zip : 91324-3879
Country : US
Telephone Number : 818-855-1788
Fax Number :
Provider Business Practice Location Address
First Line : 18860 NORDHOFF ST STE 100
Second Line :
City : NORTHRIDGE
State : CA
Zip : 91324-3879
Country : US
Telephone Number : 888-428-3223
Fax Number : 323-866-1881
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2021
Last Update Date : 05/18/2025

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Directions to “ ASOR PENA ” Practice Location

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