Provider Demographics
NPI:1932839941
Name:PASADENA ABA CENTER
Entity Type:Organization
Organization Name:PASADENA ABA CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSE NEMAZANNIKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:347-733-2596
Mailing Address - Street 1:4600 FAIRMONT PKWY STE 107
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-3336
Mailing Address - Country:US
Mailing Address - Phone:281-310-8550
Mailing Address - Fax:
Practice Address - Street 1:4600 FAIRMONT PKWY STE 107
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-3336
Practice Address - Country:US
Practice Address - Phone:281-310-8550
Practice Address - Fax:281-817-6016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty