MEDICARE: EMBERLIT ABA

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1295675114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBERLIT ABA

Provider Business Mailing Address
First Line	:	5904 WARNER AVE UNIT 532
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4670
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10311 TRASK AVE
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-3216
Country	:	US
Telephone Number	:	714-261-9385
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KIM TRAN
Credential	:
Telephone Number	:	714-786-9368

Provider Enumeration Date	:	03/31/2026
Last Update Date	:	03/31/2026

Similar Medicare Providers

1649673963 — CHRISTY SCHAEFER LAC
Practice Location Address:

2704 N EASY ST
GARDEN CITY, KS
67846-3216

Practice Phone: 620-271-8203
Practice Fax:

1578556460 — DR. SCOTT CARIELLO PHARMD
Practice Location Address:

3216 RURAL GROVE LN
LEAGUE CITY, TX
77573-5011

Practice Phone: 609-439-7679
Practice Fax:

1952353930 — DR. SHAWN ELIZABETH GURTCHEFF MD
Practice Location Address:

1446 W PLEASANT GROVE BLVD
PLEASANT GROVE, UT
84062-3216

Practice Phone: 801-785-5100
Practice Fax:

1255438636 — DR. MELINDA B HENNE MD
Practice Location Address:

1446 W PLEASANT GROVE BLVD
PLEASANT GROVE, UT
84062-3216

Practice Phone: 801-785-5100
Practice Fax: 801-785-4597

1881897908 — DR. DEIRDRE CONWAY M.D.
Practice Location Address:

1446 W PLEASANT GROVE BLVD
PLEASANT GROVE, UT
84062-3216

Practice Phone: 801-785-5100
Practice Fax:

1881960615 — VIRGINIA GARCIA MEMORIAL HEALTH CENTER
Practice Location Address:

1715 NICHOLS LN
FOREST GROVE, OR
97116-3216

Practice Phone: 503-359-4057
Practice Fax: 503-359-4756

Directions to “EMBERLIT ABA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.