Provider Demographics
NPI:1912262114
Name:SJOLUND, ANN KATRIN (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:ANN KATRIN
Middle Name:
Last Name:SJOLUND
Suffix:
Gender:F
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 1:6152 W 77TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-1642
Mailing Address - Country:US
Mailing Address - Phone:310-383-4799
Mailing Address - Fax:424-227-6714
Practice Address - Street 1:6152 W 77TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-1642
Practice Address - Country:US
Practice Address - Phone:310-383-4799
Practice Address - Fax:424-227-6714
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-04-1577103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst