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NPI Code Detail

MEDICARE: ANGELA TN LE BA, RBT

MEDICARE: ANGELA TN LE BA, 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
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y2875580OTHERCAABA THERAPY

General Provider Information

NPI Number : 1396381174
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA TN LE BA, RBT
Provider Business Mailing Address
First Line : 2601 MARBER AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-1137
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2601 MARBER AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-1137
Country : US
Telephone Number : 562-377-1027
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2019
Last Update Date : 01/23/2023

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Directions to “ ANGELA TN LE BA, RBT” Practice Location

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