Provider Demographics
NPI:1326899188
Name:OHANA BEHAVIORAL GROUP INC
Entity Type:Organization
Organization Name:OHANA BEHAVIORAL GROUP INC
Other - Org Name:OHANA BEHAVIORAL GROUP INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, BCBA
Authorized Official - Phone:562-454-7998
Mailing Address - Street 1:8646 7TH ST
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-2713
Mailing Address - Country:US
Mailing Address - Phone:562-454-7998
Mailing Address - Fax:
Practice Address - Street 1:8041 FLORENCE AVE STE 202
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3845
Practice Address - Country:US
Practice Address - Phone:562-454-7998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty