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NPI Code Detail

MEDICARE: EMILY ROSS

MEDICARE: EMILY ROSS
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 AnalystABAIN10173213OR

General Provider Information

NPI Number : 1578937132
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY ROSS
Provider Business Mailing Address
First Line : 21600 OXNARD ST
Second Line : SUITE 1800
City : WOODLAND HILLS
State : CA
Zip : 91367-4976
Country : US
Telephone Number : 818-345-2345
Fax Number : 818-449-0994
Provider Business Practice Location Address
First Line : 6400 ROSEWOOD ST
Second Line :
City : LAKE OSWEGO
State : OR
Zip : 97035-5392
Country : US
Telephone Number : 503-783-2707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2015
Last Update Date : 11/19/2015

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Directions to “ EMILY ROSS ” Practice Location

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