Provider Demographics
NPI:1841677507
Name:KAFELE, KENNETH (LEP, BCBA)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:
Last Name:KAFELE
Suffix:
Gender:M
Credentials:LEP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 HARVARD AVE # 465
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4716
Mailing Address - Country:US
Mailing Address - Phone:909-576-0170
Mailing Address - Fax:
Practice Address - Street 1:1328 W 49TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-2847
Practice Address - Country:US
Practice Address - Phone:909-538-2673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-01
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALEP3554103TS0200X
CA1-24-75871103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool