Provider Demographics
NPI:1366848269
Name:HERRERA, AIMEE (BCBA - 1-14-9590)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:HERRERA
Suffix:
Gender:F
Credentials:BCBA - 1-14-9590
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14320 VENTURA BLVD STE 794
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2717
Mailing Address - Country:US
Mailing Address - Phone:818-277-3605
Mailing Address - Fax:
Practice Address - Street 1:12711 VENTURA BLVD STE 160
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604
Practice Address - Country:US
Practice Address - Phone:818-277-3605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1149590103K00000X
CA1-14-9590103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst