Provider Demographics
NPI:1558024224
Name:ARIA BEHAVIOR CLINIC
Entity Type:Organization
Organization Name:ARIA BEHAVIOR CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GOLNOUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVAHERI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:949-295-3233
Mailing Address - Street 1:28202 CABOT RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1249
Mailing Address - Country:US
Mailing Address - Phone:949-536-7679
Mailing Address - Fax:
Practice Address - Street 1:28202 CABOT RD STE 300
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1249
Practice Address - Country:US
Practice Address - Phone:949-536-7679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty