Provider Demographics
NPI:1861880866
Name:SANDHU, BIPONPREET KAUR (MA, BCBA)
Entity type:Individual
Prefix:
First Name:BIPONPREET
Middle Name:KAUR
Last Name:SANDHU
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:BIPONPREET
Other - Middle Name:KAUR
Other - Last Name:SIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, BCBA
Mailing Address - Street 1:4515 OCEAN VIEW BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-1438
Mailing Address - Country:US
Mailing Address - Phone:818-937-0882
Mailing Address - Fax:818-937-0883
Practice Address - Street 1:4515 OCEAN VIEW BLVD STE 320
Practice Address - Street 2:
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-1438
Practice Address - Country:US
Practice Address - Phone:818-937-0882
Practice Address - Fax:818-937-0883
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-17316103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst