Provider Demographics
NPI:1578839171
Name:GREEN, KAREN (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GREEN
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:21600 OXNARD ST
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4976
Mailing Address - Country:US
Mailing Address - Phone:818-345-2345
Mailing Address - Fax:818-449-0994
Practice Address - Street 1:20101 HAMILTON AVE
Practice Address - Street 2:STE 120
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1351
Practice Address - Country:US
Practice Address - Phone:310-527-7300
Practice Address - Fax:310-527-7320
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
1-08-4263103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst