NPIMap

Connie Tieu Duong, MA, BCBA

Individual provider Active NPI Behavior Analyst · La Canada, CA

NPI 1164969986 · NPPES record last updated Nov 5, 2018

Key facts

NPI
1164969986
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-17-28387 (CA)
Practice address
4515 Ocean View Blvd Ste 320
La Canada, CA 91011-1438
Phone
(818) 937-0882
Fax
(818) 937-0883
NPI assigned
Jan 31, 2017
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
Inizio Interventions, Inc. Behavior Analyst Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-17-28387 CA Yes

Addresses

Primary practice location

4515 Ocean View Blvd Ste 320
La Canada, CA 91011-1438

Mailing address

4515 Ocean View Blvd Ste 320
La Canada, CA 91011-1438
Phone (818) 937-0882

Other practice location 1

4712 E 2nd St Ste 140
Long Beach, CA 90803-5309
Phone (818) 937-0882

Other practice location 2

17037 Chatsworth St Ste 206
Granada Hills, CA 91344-5874
Phone (818) 937-0882

Other practice location 3

1101 Fremont Ave Ste 101
S Pasadena, CA 91030-5704
Phone (818) 937-0882

Other providers in La Canada, CA

All providers in La Canada, CA · Behavior Analyst in California

Sources for this page

Verify at the official NPI Registry.