Beacon Autistic Spectrum Independence Center- B.a.s.i.c.

NPI #1750783890 in La Palma, California

Provider Information

NPI Number: 1750783890
Entity Type: Organization
Organization Name: Beacon Autistic Spectrum Independence Center- B.a.s.i.c.
Primary Specialty: Behavior Analyst
Enumeration Date: Sep 19, 2014
Last Updated: Sep 19, 2014

Practice Location

Address: 24 CENTERPOINTE DR
City: La Palma
State: California
ZIP Code: 90623-1028
Phone: (714) 288-4200

Authorized Official

Name: DR. MARY JO LANG, PHD
Title: CEO
Phone: (714) 288-4200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinical Neuropsychologist	103G00000X
Behavior Analyst	103K00000X	Primary

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