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7840 Madison Ave Ste 150 Fair Oaks CA 95628-3589 | |
| (916) 534-7572 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 7840 Madison Ave Ste 150, Fair Oaks, California |
| Authorized Official Name and Position | Kathryne Buchanan (DIRECTOR/OWNER) |
| Authorized Official Contact | 9168977653 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7840 Madison Ave Ste 150 Fair Oaks CA 95628-3589 Ph: (916) 534-7572 | 7840 Madison Ave Ste 150 Fair Oaks CA 95628-3589 Ph: (916) 534-7572 |
| NPI Number | 1700324555 |
|---|---|
| Provider Enumeration Date | 02/01/2017 |
| Last Update Date | 02/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700324555 | NPI | - | NPPES |
| 1151992 | Other | CA | BCBA |
| 566667 | Other | CA | GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1151992 (California) | Primary |
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