Provider Demographics
NPI:1720778947
Name:KATONA, JUSTIN CHARLES (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:CHARLES
Last Name:KATONA
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 ARMACOST AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-3818
Mailing Address - Country:US
Mailing Address - Phone:818-456-2547
Mailing Address - Fax:
Practice Address - Street 1:1721 ARMACOST AVE APT 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-3818
Practice Address - Country:US
Practice Address - Phone:818-456-2547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-23-65173103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst