1083044903 NPI number — AMANDA FINCH M.A., BCBA

Table of content: AMANDA FINCH M.A., BCBA (NPI 1083044903)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083044903 NPI number — AMANDA FINCH M.A., BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINCH
Provider First Name:
AMANDA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A., BCBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083044903
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
505 N BRAND BLVD
Provider Second Line Business Mailing Address:
#1000
Provider Business Mailing Address City Name:
GLENDALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91203-1906
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-241-6780
Provider Business Mailing Address Fax Number:
818-241-6853

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
28005 SMYTH DR
Provider Second Line Business Practice Location Address:
#130
Provider Business Practice Location Address City Name:
VALENCIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91355-4023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-295-4618
Provider Business Practice Location Address Fax Number:
818-241-6853
Provider Enumeration Date:
11/13/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , with the licence number:  1-13-14863 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1-13-14863 . This is a "BCBA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".