Provider Demographics
NPI:1578145082
Name:AUTISM SPECTRUM INTERVENTIONS
Entity Type:Organization
Organization Name:AUTISM SPECTRUM INTERVENTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIVISIONAL CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUWASEYI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEYINKA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:626-251-7391
Mailing Address - Street 1:713 W COMMONWEALTH AVE STE C
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1612
Mailing Address - Country:US
Mailing Address - Phone:714-879-4274
Mailing Address - Fax:714-879-2274
Practice Address - Street 1:713 W COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1612
Practice Address - Country:US
Practice Address - Phone:714-879-4274
Practice Address - Fax:714-879-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-23
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty