Provider Demographics
NPI:1619535770
Name:RYLEY, JOCASTA (BCABA)
Entity Type:Individual
Prefix:
First Name:JOCASTA
Middle Name:
Last Name:RYLEY
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 W CENTINELA AVE STE 380
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6367
Mailing Address - Country:US
Mailing Address - Phone:310-337-7827
Mailing Address - Fax:310-337-7840
Practice Address - Street 1:6101 W CENTINELA AVE STE 380
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6367
Practice Address - Country:US
Practice Address - Phone:310-337-7827
Practice Address - Fax:310-337-7840
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst