Provider Demographics
NPI:1326730243
Name:SACRAMENTO ABA THERAPY LLC
Entity type:Organization
Organization Name:SACRAMENTO ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:KOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-272-1570
Mailing Address - Street 1:2035 HURLEY WAY STE 900
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-3233
Mailing Address - Country:US
Mailing Address - Phone:916-272-1570
Mailing Address - Fax:916-405-3460
Practice Address - Street 1:2035 HURLEY WAY STE 900
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-3233
Practice Address - Country:US
Practice Address - Phone:916-272-1570
Practice Address - Fax:916-405-3460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty