Provider Demographics
NPI:1043946247
Name:NATARENO, MICHELLE (MS ABA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:NATARENO
Suffix:
Gender:F
Credentials:MS ABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12703 ARCHWOOD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-1213
Mailing Address - Country:US
Mailing Address - Phone:818-438-3941
Mailing Address - Fax:
Practice Address - Street 1:5435 BALBOA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1508
Practice Address - Country:US
Practice Address - Phone:310-933-4499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician