Provider Demographics
NPI:1417235458
Name:REJON, SOFIA SANCHEZ (BCBA)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:SANCHEZ
Last Name:REJON
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 1:16719 ROSCOE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-6110
Mailing Address - Country:US
Mailing Address - Phone:888-516-3896
Mailing Address - Fax:877-262-9136
Practice Address - Street 1:2171 CAMPUS DR
Practice Address - Street 2:#260
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1422
Practice Address - Country:US
Practice Address - Phone:877-285-6430
Practice Address - Fax:877-285-6431
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-11-8469103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst