Provider Demographics
NPI:1760022529
Name:SEABROOKS, ALISHA NYKIA (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:NYKIA
Last Name:SEABROOKS
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25563 ESTRELLAS LN
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92551-7037
Mailing Address - Country:US
Mailing Address - Phone:760-277-0552
Mailing Address - Fax:
Practice Address - Street 1:5005 CANYON CREST DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-7721
Practice Address - Country:US
Practice Address - Phone:951-346-4860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-19-39244103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst