MEDICARE: ELLIS AUBUCHON

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
1	103K00000X	Behavior Analyst	1-26-88028	CA

General Provider Information

NPI Number	:	1770211419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLIS AUBUCHON

Provider Business Mailing Address
First Line	:	4127 HILLPARK CT
Second Line	:
City	:	MOORPARK
State	:	CA
Zip	:	93021-3735
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18200 RINALDI PL
Second Line	:
City	:	PORTER RANCH
State	:	CA
Zip	:	91326-2551
Country	:	US
Telephone Number	:	818-690-6274
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2022
Last Update Date	:	02/27/2026

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Directions to “ ELLIS AUBUCHON ” Practice Location

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