Provider Demographics
NPI:1437490661
Name:KUDERNA-WINN, SONJA LEANNE (BCBA)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:LEANNE
Last Name:KUDERNA-WINN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SONJA
Other - Middle Name:LEANNE
Other - Last Name:KUDERNA-WINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA
Mailing Address - Street 1:15720 VENTURA BLVD
Mailing Address - Street 2:403
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2914
Mailing Address - Country:US
Mailing Address - Phone:818-788-2388
Mailing Address - Fax:818-788-3875
Practice Address - Street 1:15720 VENTURA BLVD
Practice Address - Street 2:403
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2914
Practice Address - Country:US
Practice Address - Phone:818-788-2388
Practice Address - Fax:818-788-3875
Is Sole Proprietor?:No
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-11-7973103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst