Provider Demographics
NPI:1912677592
Name:ROCK-BYRAM, CECILY (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:CECILY
Middle Name:
Last Name:ROCK-BYRAM
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 1:351 JENNY DR
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-2921
Mailing Address - Country:US
Mailing Address - Phone:805-410-0196
Mailing Address - Fax:
Practice Address - Street 1:5000 PARKWAY CALABASAS STE 103
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3904
Practice Address - Country:US
Practice Address - Phone:818-869-2237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst