Provider Demographics
NPI:1285222463
Name:BAHENA, AMINADAB YAMANI SR
Entity Type:Individual
Prefix:MR
First Name:AMINADAB
Middle Name:YAMANI
Last Name:BAHENA
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8134 VAN NUYS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4818
Mailing Address - Country:US
Mailing Address - Phone:866-590-6411
Mailing Address - Fax:
Practice Address - Street 1:8134 VAN NUYS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4818
Practice Address - Country:US
Practice Address - Phone:866-590-6411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty