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NPI Code Detail

MEDICARE: MS. KATELYN ANNE GIBONEY B.C.B.A.

MEDICARE:  MS. KATELYN ANNE GIBONEY  B.C.B.A.
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 Analyst

General Provider Information

NPI Number : 1437487691
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATELYN ANNE GIBONEY B.C.B.A.
Provider Business Mailing Address
First Line : 19019 VENTURA BLVD
Second Line :
City : TARZANA
State : CA
Zip : 91356-3253
Country : US
Telephone Number : 818-345-2345
Fax Number : 866-587-2383
Provider Business Practice Location Address
First Line : 21600 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7807
Country : US
Telephone Number : 183-452-3458
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2009
Last Update Date : 05/14/2020

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Directions to “ MS. KATELYN ANNE GIBONEY B.C.B.A.” Practice Location

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