MEDICARE: AURORA BEHAVIORAL CONSULTANTS, L.L.C.

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

General Provider Information

NPI Number	:	1861082109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AURORA BEHAVIORAL CONSULTANTS, L.L.C.

Provider Business Mailing Address
First Line	:	13 MISSION PLAZA DR
Second Line	:
City	:	VENTURA
State	:	CA
Zip	:	93001-2672
Country	:	US
Telephone Number	:	562-380-0754
Fax Number	:

Provider Business Practice Location Address
First Line	:	342 ORANGE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-3538
Country	:	US
Telephone Number	:	562-380-0754
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	KATHLEEN JOY SMITH
Credential	:	BCBA
Telephone Number	:	907-862-7776

Provider Enumeration Date	:	01/20/2021
Last Update Date	:	01/20/2021

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