Provider Demographics
NPI:1710431317
Name:INSTITUTE FOR EFFECTIVE BEHAVIORAL INTERVENTIONS
Entity Type:Organization
Organization Name:INSTITUTE FOR EFFECTIVE BEHAVIORAL INTERVENTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FUNDING COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MAGDALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORONA
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:818-501-0822
Mailing Address - Street 1:17200 VENTURA BLVD STE 125
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4030
Mailing Address - Country:US
Mailing Address - Phone:818-501-0822
Mailing Address - Fax:818-501-0820
Practice Address - Street 1:17200 VENTURA BLVD STE 125
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4030
Practice Address - Country:US
Practice Address - Phone:818-501-0822
Practice Address - Fax:818-501-0820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11622427103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty