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NPI Code Detail

MEDICARE: JUSTICE MAMARADLO

MEDICARE: JUSTICE MAMARADLO
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 : 1427949460
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTICE MAMARADLO
Provider Business Mailing Address
First Line : 4221 WILSHIRE BLVD STE 300A
Second Line :
City : LOS ANGELES
State : CA
Zip : 90010-3537
Country : US
Telephone Number : 888-428-3223
Fax Number : 323-866-1881
Provider Business Practice Location Address
First Line : 4221 WILSHIRE BLVD STE 300A
Second Line :
City : LOS ANGELES
State : CA
Zip : 90010-3537
Country : US
Telephone Number : 888-428-3223
Fax Number : 323-866-1881
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2025
Last Update Date : 04/14/2026

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Directions to “ JUSTICE MAMARADLO ” Practice Location

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