Provider Demographics
NPI:1174989362
Name:HERRERA, JOE ALEXANDER (BCBA)
Entity type:Individual
Prefix:MR
First Name:JOE
Middle Name:ALEXANDER
Last Name:HERRERA
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18547 COLLINS ST APT B9
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2253
Mailing Address - Country:US
Mailing Address - Phone:310-387-2780
Mailing Address - Fax:
Practice Address - Street 1:18547 COLLINS ST APT B9
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2253
Practice Address - Country:US
Practice Address - Phone:310-387-2780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-20653103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst