Provider Demographics
NPI:1740007996
Name:RANDLE-BENJAMIN ABA CONSULTANTS LLC
Entity type:Organization
Organization Name:RANDLE-BENJAMIN ABA CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-CLINICAL
Authorized Official - Prefix:
Authorized Official - First Name:NYVIA
Authorized Official - Middle Name:NAKINMEYAH
Authorized Official - Last Name:RANDLE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:626-612-6005
Mailing Address - Street 1:25185 MADISON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-8977
Mailing Address - Country:US
Mailing Address - Phone:626-612-6005
Mailing Address - Fax:
Practice Address - Street 1:25185 MADISON AVE STE A
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8977
Practice Address - Country:US
Practice Address - Phone:626-612-6005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty