Crisolo, Cedric

Crisolo, Cedric is an individual health care provider with primary practice located at 17609 Ventura Blvd St. 215, Encino CA 91316-3858. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Crisolo, Cedric can be contacted via phone (818) 501-8352.

Contact Information

Primary practice address
17609 Ventura Blvd St. 215 Encino CA 91316-3858
Phone: (818) 501-8352
Fax: (818) 501-8325
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 11314656 California

Profile Details

NPI number 1053644013
LBN Legal business name Crisolo, Cedric
Credentials M.A., BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2009
Last updated Nov 22nd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053644013 NPPES
California MEDICAID 7068
California MEDICAID 7420

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