Individual
KODII CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
312 S JUNIPER ST STE 202, ESCONDIDO, CA 92025-4998
(888) 428-3223
(323) 866-1881
Mailing address
4221 WILSHIRE BLVD STE 300A, LOS ANGELES, CA 90010-3537
(888) 428-3223
(323) 866-1881
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT
BEHAVIOR HEALTH
CA
Enumeration date
09/08/2020
Last updated
09/01/2021
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