Stephanie Carolina Bernal Ulloa
Individual provider Active NPI Behavior Analyst · Walnut Park, CA
NPI 1083115463 · NPPES record last updated Feb 22, 2018
Key facts
- NPI
- 1083115463
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- F5218395 (CA)
- Practice address
- 7400 Pacific Blvd Ste a&B
Walnut Park, CA 90255-5739 - Phone
- (323) 538-9050
- NPI assigned
- Feb 22, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F5218395 | CA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jessica Lieber, M.S., Bcba | Behavior Analyst | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | F5218395 | CA | Yes |
Addresses
Primary practice location
7400 Pacific Blvd Ste a&B
Walnut Park, CA 90255-5739
Mailing address
21600 Oxnard St Ste 1800
Woodland Hills, CA 91367-7807
Phone (818) 345-2345
Other providers in Walnut Park, CA
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- Natalie Ayala
- Paola Ayala
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- Melissa Chavez-Arroyo
- Adriana Catalina Cisneros
- Teresa Cosio de Silva
- Cesar Davila
All providers in Walnut Park, CA · Behavior Analyst in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.