Provider Demographics
NPI:1063860898
Name:AUTISM BEHAVIOR CONSULTANTS
Entity Type:Organization
Organization Name:AUTISM BEHAVIOR CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:C
Authorized Official - Last Name:AGUIRRE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:310-320-1333
Mailing Address - Street 1:2909 OREGON CT
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-2645
Mailing Address - Country:US
Mailing Address - Phone:310-320-1333
Mailing Address - Fax:310-320-6555
Practice Address - Street 1:1880 TOWN AND COUNTRY DR
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-3621
Practice Address - Country:US
Practice Address - Phone:310-320-1333
Practice Address - Fax:310-320-6555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health