Provider Demographics
NPI:1023421054
Name:KAUFMAN, SARA BETH (MS, BCBA)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:BETH
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6428
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91510-6428
Mailing Address - Country:US
Mailing Address - Phone:323-850-7177
Mailing Address - Fax:323-850-7747
Practice Address - Street 1:5949 LANKERSHIM BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-1006
Practice Address - Country:US
Practice Address - Phone:323-850-7177
Practice Address - Fax:323-850-7747
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABCBA 1-11-9639103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst