Matthew Thomas Dolan

Individual provider Active NPI Behavior Analyst · Tehachapi, CA

NPI 1073154076 · NPPES record last updated Jan 19, 2020

Key facts

NPI
1073154076
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-19-38201 (CA)
Practice address
26300 Chester CT
Tehachapi, CA 93561-7476
Phone
(714) 600-9529
NPI assigned
Oct 1, 2019
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Behavior Education Analysis & Research LLC Behavior Analyst Current
since Jan 26, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-19-38201 CA Yes

Addresses

Primary practice location

26300 Chester CT
Tehachapi, CA 93561-7476

Mailing address

26300 Chester CT
Tehachapi, CA 93561-7476
Phone (714) 600-9529

Other providers in Tehachapi, CA

All providers in Tehachapi, CA · Behavior Analyst in California

Sources for this page

Verify at the official NPI Registry.