Provider Demographics
NPI:1518583053
Name:JOURNEY WITH ABA
Entity type:Organization
Organization Name:JOURNEY WITH ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/ FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:NIRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRIANIFAHANANA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:571-490-1813
Mailing Address - Street 1:2521 W SUNFLOWER AVE UNIT J11
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-8514
Mailing Address - Country:US
Mailing Address - Phone:571-490-1813
Mailing Address - Fax:
Practice Address - Street 1:2521 W SUNFLOWER AVE UNIT J11
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-8514
Practice Address - Country:US
Practice Address - Phone:571-490-1813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-20
Last Update Date:2020-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty