Provider Demographics
NPI:1639753544
Name:RAMOS ESTRADA, CHRISTIAN JOSE (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:JOSE
Last Name:RAMOS ESTRADA
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6245 CAHUENGA BLVD APT 5
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3900
Mailing Address - Country:US
Mailing Address - Phone:818-326-9698
Mailing Address - Fax:
Practice Address - Street 1:1093 BROXTON AVE STE 240
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-2831
Practice Address - Country:US
Practice Address - Phone:310-871-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12149597103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst