Provider Demographics
NPI:1972940963
Name:GUTTERSON-CAHILL, RYAN (BCBA)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:GUTTERSON-CAHILL
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:MR
Other - First Name:RYAN
Other - Middle Name:
Other - Last Name:GUTTERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15001 DICKENS ST APT D
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3432
Mailing Address - Country:US
Mailing Address - Phone:323-445-3994
Mailing Address - Fax:
Practice Address - Street 1:15001 DICKENS STREET UNIT D
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403
Practice Address - Country:US
Practice Address - Phone:323-445-3994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-11-8293103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst