Provider Demographics
NPI:1023405982
Name:HEARTS OF ABA
Entity type:Organization
Organization Name:HEARTS OF ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KHANG
Authorized Official - Middle Name:DUY
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:714-623-3597
Mailing Address - Street 1:8022 LA MONTE RD
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:CA
Mailing Address - Zip Code:90680-3626
Mailing Address - Country:US
Mailing Address - Phone:833-922-2669
Mailing Address - Fax:714-592-4401
Practice Address - Street 1:8022 LA MONTE RD
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:CA
Practice Address - Zip Code:90680-3626
Practice Address - Country:US
Practice Address - Phone:833-922-2669
Practice Address - Fax:714-592-4401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABCBA 1-11-8873103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty