Chanisara Kitpetnee, M.A., B.C.B.A.

Individual provider Active NPI Behavior Analyst · Encino, CA

NPI 1124415260 · NPPES record last updated Apr 15, 2015

Key facts

NPI
1124415260
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
Practice address
15720 Ventura Blvd
#403
Encino, CA 91436-2914
Phone
(818) 788-2388
NPI assigned
Apr 15, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Child Counseling & Behavior Therapy Clinic Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Yes

Addresses

Primary practice location

15720 Ventura Blvd
#403
Encino, CA 91436-2914

Mailing address

15720 Ventura Blvd
#403
Encino, CA 91436-2914

Other providers in Encino, CA

All providers in Encino, CA · Behavior Analyst in California

Sources for this page

Verify at the official NPI Registry.