Selah Aliyah Bourne

Individual provider Active NPI Behavior Analyst · Mentone, CA

NPI 1205720331 · NPPES record last updated Jun 4, 2025

Key facts

NPI
1205720331
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
Practice address
1356 Beryl Ave
Mentone, CA 92359-1206
Phone
(760) 881-8369
NPI assigned
Jun 4, 2025
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Yes

Addresses

Primary practice location

1356 Beryl Ave
Mentone, CA 92359-1206

Mailing address

1356 Beryl Ave
Mentone, CA 92359-1206
Phone (760) 881-8369

Other providers in Mentone, CA

All providers in Mentone, CA · Behavior Analyst in California

Sources for this page

Verify at the official NPI Registry.