Provider Demographics
NPI:1104666114
Name:THE NEST LOS ANGELES LLC
Entity type:Organization
Organization Name:THE NEST LOS ANGELES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATON
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:KENNEY
Authorized Official - Last Name:FUNK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-422-3609
Mailing Address - Street 1:11425 MOORPARK ST
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91602-2009
Mailing Address - Country:US
Mailing Address - Phone:310-920-8544
Mailing Address - Fax:888-420-6257
Practice Address - Street 1:11425 MOORPARK ST
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91602-2009
Practice Address - Country:US
Practice Address - Phone:310-920-8544
Practice Address - Fax:888-420-6257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty