| |
55 Declaration Dr Ste B Chico CA 95973-4965 | |
(530) 487-7265 | |
(530) 487-7263 |
Full Name | |
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Speciality | Behavior Analyst |
Location | 55 Declaration Dr Ste B, Chico, California |
Authorized Official Name and Position | David Charlon (CEO) |
Authorized Official Contact | 5304877265 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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55 Declaration Dr Ste B Chico CA 95973-4965 Ph: (304) 877-2655 | 55 Declaration Dr Ste B Chico CA 95973-4965 Ph: (530) 487-7265 |
NPI Number | 1396149233 |
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Provider Enumeration Date | 10/21/2014 |
Last Update Date | 08/15/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396149233 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | 1-10-7196 (California) | Primary |
252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Secondary |
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