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NPI Code Detail

MEDICARE: MARA BETHANY FELIX

MEDICARE: MARA BETHANY FELIX
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 Analyst10250TX
2103K00000XBehavior Analyst1-17-26677CA

General Provider Information

NPI Number : 1306304100
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARA BETHANY FELIX
Provider Business Mailing Address
First Line : 400 CONTINENTAL BLVD FL 6
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-5074
Country : US
Telephone Number : 310-310-2931
Fax Number :
Provider Business Practice Location Address
First Line : 6320 CANOGA AVE FL 15
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-2563
Country : US
Telephone Number : 818-894-2273
Fax Number : 818-357-2505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2019
Last Update Date : 05/29/2026

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