Provider Demographics
NPI:1306562582
Name:CASCADE ABA SERVICES
Entity type:Organization
Organization Name:CASCADE ABA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:MASOOMEH
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIFPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:949-633-8255
Mailing Address - Street 1:23986 ALISO CREEK RD # 761
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-3908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:31526 SEA SHADOWS WAY
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-5409
Practice Address - Country:US
Practice Address - Phone:949-633-8255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty