Corebridge ABA Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

COREBRIDGE ABA INC

Practice address

333 E Glenoaks Blvd Ste 101
Glendale, CA 91207-2096

Phone

(323) 533-3777

NPI assigned

Aug 4, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kim Mitchell Potter, BCBA

Title

Consutant

Phone

(201) 978-3815

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1785801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1750204822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E GLENOAKS BLVD STE 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912072096",
            "telephone_number": "323-533-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E GLENOAKS BLVD STE 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912072096",
            "telephone_number": "323-533-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COREBRIDGE ABA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-04",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "CONSUTANT",
        "authorized_official_telephone_number": "201-978-3815",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.