MEDICARE: PARENT COACHING 4 BEHAVIOR, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1194674614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARENT COACHING 4 BEHAVIOR, LLC

Provider Business Mailing Address
First Line	:	33 ECHO AVE APT 2
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94611-4352
Country	:	US
Telephone Number	:	619-988-8288
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 ECHO AVE APT 2
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94611-4352
Country	:	US
Telephone Number	:	619-988-8288
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	CAMERON MATTHEWS
Credential	:	BCBA, LBA
Telephone Number	:	619-988-8288

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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