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Organization
SOURCE 1 BEHAVIORAL SERVICES, LLC
Active
Organization
SOURCE 1 BEHAVIORAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE MARIE BAKER BCBA (EXECUTIVE DIRECTOR/OWNER)
(562) 708-7639
Entity
Organization
Contact information
Practice address
222 W 6TH ST STE 400, SAN PEDRO, CA 90731-3345
(562) 708-7639
Mailing address
222 W 6TH ST STE 400, SAN PEDRO, CA 90731-3345
(562) 708-7639
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/10/2021
Last updated
09/11/2025
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