Organization
ABA WEISSENBERG ELITE BEHAVIORAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA DICKERSON BCBA (CLINICAL DIRECTOR)
(208) 995-3615
Entity
Organization
Contact information
Practice address
4930 CAMPUS DR, NEWPORT BEACH, CA 92660-2119
(208) 995-3615
(833) 275-1309
Mailing address
PO BOX 1519, MERIDIAN, ID 83680-1519
(208) 995-3615
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-14-10119
CA
251S00000X
Community/Behavioral Health Agency
Primary
1-14-10119
CA
Other
Enumeration date
08/21/2018
Last updated
07/29/2024
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