Provider Demographics
NPI:1902382153
Name:KYEI, ABIGAIL BAFFOUR
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:BAFFOUR
Last Name:KYEI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13444 BURBANK BLVD APT 6
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-5312
Mailing Address - Country:US
Mailing Address - Phone:774-321-4257
Mailing Address - Fax:
Practice Address - Street 1:6200 STONERIDGE MALL RD STE 300
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3705
Practice Address - Country:US
Practice Address - Phone:888-773-4359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-23-70371103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst