Provider Demographics
NPI:1760803209
Name:ABAWORKS LLC.
Entity Type:Organization
Organization Name:ABAWORKS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:909-621-0713
Mailing Address - Street 1:969 S VILLAGE OAKS DR STE 204
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-0606
Mailing Address - Country:US
Mailing Address - Phone:909-621-0713
Mailing Address - Fax:866-579-6146
Practice Address - Street 1:969 S VILLAGE OAKS DR STE 204
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-0606
Practice Address - Country:US
Practice Address - Phone:909-621-0713
Practice Address - Fax:866-579-6146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-31
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-11-9303251S00000X
CA1-11-8970251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health