MEDICARE: MS. ROYA MAYER 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
1	103K00000X	Behavior Analyst	1-19-37813	CA

General Provider Information

NPI Number	:	1982877304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROYA MAYER BCBA

Provider Business Mailing Address
First Line	:	PO BOX 49177
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-0177
Country	:	US
Telephone Number	:	310-295-8591
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 S BARRINGTON AVE # 177
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-7939
Country	:	US
Telephone Number	:	310-295-8591
Fax Number	:

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

Provider Enumeration Date	:	04/07/2008
Last Update Date	:	04/24/2020

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