Healthcare Provider Details

I. General information

NPI: 1285494427
Provider Name (Legal Business Name): AMAZE BEHAVIOR CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 BROCKTON WAY
ASHLAND CA
94578-2138
US

IV. Provider business mailing address

1624 BROCKTON WAY
ASHLAND CA
94578-2138
US

V. Phone/Fax

Practice location:
  • Phone: 510-294-9525
  • Fax:
Mailing address:
  • Phone: 559-772-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TRINA TORRES
Title or Position: CLINICAL OFFICER
Credential:
Phone: 559-772-2222