Healthcare Provider Details

I. General information

NPI: 1679086417
Provider Name (Legal Business Name): B & D ASSESSMENT AND CONSULTING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2017
Last Update Date: 11/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26565 WEST AGOURA RD STE 200
CALABASAS CA
91302-1990
US

IV. Provider business mailing address

26565 WEST AGOURA ROAD, SUITE 200
CALABASAS CA
91302
US

V. Phone/Fax

Practice location:
  • Phone: 818-483-6630
  • Fax:
Mailing address:
  • Phone: 310-341-9729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-13-13840
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY27372
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY27372
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY27372
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPSY27372
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberPSY27372
License Number StateCA

VIII. Authorized Official

Name: KRISTINA GRUBBS
Title or Position: BEHAVIOR ANALYST
Credential: BCBA
Phone: 818-483-6630