MEDICARE: BUILDING BLOCKS BEHAVIOR CONSULTANTS

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	251S00000X	Community/Behavioral Health Agency	145752	CA

General Provider Information

NPI Number	:	1417245218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUILDING BLOCKS BEHAVIOR CONSULTANTS

Provider Business Mailing Address
First Line	:	214 ESTATES DR
Second Line	:	SUITE A
City	:	ROSEVILLE
State	:	CA
Zip	:	95678-2353
Country	:	US
Telephone Number	:	916-749-4646
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 ESTATES DR
Second Line	:	SUITE A
City	:	ROSEVILLE
State	:	CA
Zip	:	95678-2353
Country	:	US
Telephone Number	:	916-749-4646
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MILA DEL PILAR ZEA
Credential	:	M. ED. BCBA
Telephone Number	:	916-716-9960

Provider Enumeration Date	:	07/13/2011
Last Update Date	:	09/12/2014

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