Provider Demographics
NPI:1780218966
Name:GANEWATTE, ARUNI (MS)
Entity Type:Individual
Prefix:
First Name:ARUNI
Middle Name:
Last Name:GANEWATTE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MR
Other - First Name:ARUNI
Other - Middle Name:
Other - Last Name:GANEWATTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:223 E THOUSAND OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5803
Mailing Address - Country:US
Mailing Address - Phone:818-644-9665
Mailing Address - Fax:
Practice Address - Street 1:4685 VIA DEL RANCHO
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-6745
Practice Address - Country:US
Practice Address - Phone:818-644-9665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst