Healthcare Provider Details

I. General information

NPI: 1649577966
Provider Name (Legal Business Name): DEIDRA LYNN MEYERS BCBA 1-07-3313
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2011
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 CAMARILLO SPRINGS RD STE D
CAMARILLO CA
93012-9460
US

IV. Provider business mailing address

200 FRENCHYS CV APT 17
CAMARILLO CA
93012-9155
US

V. Phone/Fax

Practice location:
  • Phone: 916-990-2104
  • Fax:
Mailing address:
  • Phone: 916-990-2104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-07-3313
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: