Provider Demographics
NPI:1760758841
Name:BERLIN, ARLENE LEBRILLA (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:LEBRILLA
Last Name:BERLIN
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:JOY LAVILLA
Other - Last Name:LEBRILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:17203 VENTURA BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4051
Mailing Address - Country:US
Mailing Address - Phone:818-501-3615
Mailing Address - Fax:818-501-3649
Practice Address - Street 1:17203 VENTURA BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4051
Practice Address - Country:US
Practice Address - Phone:818-501-3615
Practice Address - Fax:818-501-3649
Is Sole Proprietor?:No
Enumeration Date:2012-03-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-10-7088103K00000X
CA17391235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
12208960OtherCAQH