Provider Demographics
NPI:1164762068
Name:COX, REBECCA LYNN (BCBA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:COX
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 1:31344 VIA COLINAS STE 108
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-6797
Mailing Address - Country:US
Mailing Address - Phone:818-805-1215
Mailing Address - Fax:818-874-3004
Practice Address - Street 1:31344 VIA COLINAS STE 108
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362
Practice Address - Country:US
Practice Address - Phone:818-805-1215
Practice Address - Fax:818-874-3004
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-13-12820103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst