Individual provider · NPI-1

Ivanna Samantha Acosta, MS

Behavior Analyst · Gardena, CA

NPI number1790451268
StatusActive
Last updated in NPPESAug 17, 2021

Details

NPI
1790451268
Entity type
Individual (NPI-1)
Name
Ivanna Samantha Acosta
Credential
MS
Sex
Female
Sole proprietor
No
Enumeration date
Aug 17, 2021
Certification date
Aug 17, 2021
Last updated
Aug 17, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103K00000X Behavior Analyst––Yes

Practice location

1515 W 190th St Ste 300
Gardena, CA 90248-4925

Phone 310-819-4523 · Fax 877-394-6799

Mailing address

1515 W 190th St Ste 300
Gardena, CA 90248-4925

Phone 310-819-4523 · Fax 877-394-6799

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