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NPI Code Detail

MEDICARE: SARAH ALEXANDRA SHELLHORN BCBA

MEDICARE: SARAH ALEXANDRA SHELLHORN 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 TechnicianCA
2103K00000XBehavior Analyst1-22-57675CA

General Provider Information

NPI Number : 1639617749
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH ALEXANDRA SHELLHORN BCBA
Provider Business Mailing Address
First Line : 4858 MUIRWOOD CT
Second Line :
City : SIMI VALLEY
State : CA
Zip : 93063-2451
Country : US
Telephone Number : 805-304-5271
Fax Number :
Provider Business Practice Location Address
First Line : 6160 PLUMAS ST STE 100
Second Line :
City : RENO
State : NV
Zip : 89519-6057
Country : US
Telephone Number : 775-316-8386
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2017
Last Update Date : 02/05/2026

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