Organization
ABA WORKS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WILLEMIJN JOHANNA CAMPBELL BCBA, MFT (CLINICAL DIRECTOR)
(310) 456-4937
Entity
Organization
Contact information
Practice address
11340 W OLYMPIC BLVD, 250, LOS ANGELES, CA 90064-1608
(310) 456-4937
(888) 286-8715
Mailing address
2633 LINCOLN BLVD, 520, SANTA MONICA, CA 90405
(310) 456-4937
(888) 286-8715
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
MFC47309
CA
106H00000X
Marriage & Family Therapist
MFC47309
CA
251S00000X
Community/Behavioral Health Agency
11212499
CA
252Y00000X
Early Intervention Provider Agency
11212499
CA
Other
Enumeration date
10/02/2014
Last updated
10/02/2014
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