Provider Demographics
NPI:1225495492
Name:MENDELSOHN, HANNAH (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:MENDELSOHN
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 1:23030 LYONS AVE
Mailing Address - Street 2:#200
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2752
Mailing Address - Country:US
Mailing Address - Phone:661-425-7066
Mailing Address - Fax:661-297-8282
Practice Address - Street 1:23030 LYONS AVE
Practice Address - Street 2:#200
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2752
Practice Address - Country:US
Practice Address - Phone:661-425-7066
Practice Address - Fax:661-297-8282
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-20779103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1-15-20779OtherBCBA