Provider Demographics
NPI:1669009429
Name:LEPTICH M.S., BCBA, SARA L
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:LEPTICH M.S., BCBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:692 SPRING OAK RD UNIT 712
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-7544
Mailing Address - Country:US
Mailing Address - Phone:760-550-1305
Mailing Address - Fax:
Practice Address - Street 1:692 SPRING OAK RD UNIT 712
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-7544
Practice Address - Country:US
Practice Address - Phone:760-550-1305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst