Individual
ANDREA VAN DEVENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
22800 LYONS AVE STE 110, NEWHALL, CA 91321-2897
(818) 208-0164
Mailing address
24595 TOWN CENTER DR APT 3102, SANTA CLARITA, CA 91355-1382
(818) 208-0164
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-23-65923
ID
103K00000X
Behavior Analyst
Primary
12365923
CA
103K00000X
Behavior Analyst
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Other
Enumeration date
10/25/2023
Last updated
11/01/2024
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