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NPI Code Detail

MEDICARE: KATELYN BOBO

MEDICARE: KATELYN BOBO
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

General Provider Information

NPI Number : 1346103132
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN BOBO
Provider Business Mailing Address
First Line : 2550 N HOLLYWOOD WAY STE 301
Second Line :
City : BURBANK
State : CA
Zip : 91505-5025
Country : US
Telephone Number : 866-727-8274
Fax Number :
Provider Business Practice Location Address
First Line : 3041 W HORIZON RIDGE PKWY STE 150
Second Line :
City : HENDERSON
State : NV
Zip : 89052-4445
Country : US
Telephone Number : 866-727-8274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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Directions to “ KATELYN BOBO ” Practice Location

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