Provider Demographics
NPI:1073995825
Name:AYOUBKHAN, SIMONE NOELLE (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:SIMONE
Middle Name:NOELLE
Last Name:AYOUBKHAN
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2462 ALTA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-8631
Mailing Address - Country:US
Mailing Address - Phone:209-968-7449
Mailing Address - Fax:
Practice Address - Street 1:2462 ALTA VISTA ST
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-8631
Practice Address - Country:US
Practice Address - Phone:209-968-7449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-28
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-11-9397103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst