Provider Demographics
NPI:1760992747
Name:AMIN, NIRZARI B (BCBA)
Entity Type:Individual
Prefix:
First Name:NIRZARI
Middle Name:B
Last Name:AMIN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 W HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4264
Mailing Address - Country:US
Mailing Address - Phone:805-379-1401
Mailing Address - Fax:805-650-1385
Practice Address - Street 1:299 W HILLCREST DR
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4264
Practice Address - Country:US
Practice Address - Phone:805-379-1401
Practice Address - Fax:805-065-0138
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst