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NPI Code Detail

MEDICARE: EBRULPHUES SAWAKI WERIA BCBA

MEDICARE: EBRULPHUES SAWAKI WERIA BCBA
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 : 1467303289
Entity Type Code : Individual
Provider Name (Legal Business Name) : EBRULPHUES SAWAKI WERIA BCBA
Provider Business Mailing Address
First Line : 100 N PACIFIC COAST HWY
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-4359
Country : US
Telephone Number : 310-856-0800
Fax Number : 855-568-2494
Provider Business Practice Location Address
First Line : 3111 124TH AVE NW STE 150
Second Line :
City : COON RAPIDS
State : MN
Zip : 55433-4581
Country : US
Telephone Number : 612-594-8405
Fax Number : 855-568-2494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2026
Last Update Date : 02/06/2026

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