Provider Demographics
NPI:1003313347
Name:HAROAN, VANESSA (BCBA)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:HAROAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 E HUNTINGTON DR STE 300
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3775
Mailing Address - Country:US
Mailing Address - Phone:626-230-4094
Mailing Address - Fax:725-500-5882
Practice Address - Street 1:440 E HUNTINGTON DR STE 300
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3775
Practice Address - Country:US
Practice Address - Phone:626-230-4094
Practice Address - Fax:725-500-5882
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1-19-40263103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVLBA0312OtherNEVADA APPLIED BEHAVIOR ANALYST BOARD
NV250009908Medicaid
1-19-40263OtherBEHAVIOR ANALYST CERTIFICATION BOARD