Provider Demographics
NPI:1154798114
Name:BATUGO, CHARISSE MAE PASCUAL (MA, BCBA)
Entity type:Individual
Prefix:
First Name:CHARISSE MAE
Middle Name:PASCUAL
Last Name:BATUGO
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:CHARISSE
Other - Middle Name:PASCUAL
Other - Last Name:BATUGO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, BCBA
Mailing Address - Street 1:13030 CHASE ST
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-4209
Mailing Address - Country:US
Mailing Address - Phone:818-300-2802
Mailing Address - Fax:
Practice Address - Street 1:13030 CHASE ST
Practice Address - Street 2:
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-4209
Practice Address - Country:US
Practice Address - Phone:818-300-2802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-18642103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst