Provider Demographics
NPI:1881119808
Name:MERLOS, LUIS (BCBA)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:MERLOS
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 W CENTINELA AVE STE 380
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6367
Mailing Address - Country:US
Mailing Address - Phone:310-337-7827
Mailing Address - Fax:
Practice Address - Street 1:6101 W CENTINELA AVE STE 380
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6367
Practice Address - Country:US
Practice Address - Phone:310-337-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-17-26443103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst