Provider Demographics
NPI:1194503631
Name:WEST COAST ABA
Entity type:Organization
Organization Name:WEST COAST ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:951-313-7203
Mailing Address - Street 1:27945 GREENSPOT RD # 1035
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-4440
Mailing Address - Country:US
Mailing Address - Phone:714-319-5695
Mailing Address - Fax:
Practice Address - Street 1:8526 HICKORY LN
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-2915
Practice Address - Country:US
Practice Address - Phone:714-319-5695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty