Michelle David, BCBA

Individual provider Active NPI Behavior Analyst · Alta Loma, CA

NPI 1053740522 · NPPES record last updated Nov 5, 2013

Key facts

NPI
1053740522
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
BCBA 1-11-8738
Practice address
8780 19TH St Unit 398
Alta Loma, CA 91701-4608
Phone
(888) 618-2327
Fax
(888) 918-2327
NPI assigned
Nov 5, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BCBA 1-11-8738 Yes

Addresses

Primary practice location

8780 19TH St Unit 398
Alta Loma, CA 91701-4608

Mailing address

8780 19TH St Unit 398
Alta Loma, CA 91701-4608
Phone (888) 618-2327

Other providers in Alta Loma, CA

All providers in Alta Loma, CA · Behavior Analyst in California

Sources for this page

Verify at the official NPI Registry.