Provider Demographics
NPI:1487272092
Name:PAGLINAWAN, ADRIENNE (MS, BCBA)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:PAGLINAWAN
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 1:24516 NARBONNE AVE APT B
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-1189
Mailing Address - Country:US
Mailing Address - Phone:310-940-7739
Mailing Address - Fax:
Practice Address - Street 1:24516 NARBONNE AVE APT B
Practice Address - Street 2:
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-1189
Practice Address - Country:US
Practice Address - Phone:310-940-7739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CA1-23-67682103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician