Healthcare Provider Details

I. General information

NPI: 1619588118
Provider Name (Legal Business Name): INDIVIDUALIZED ABA SERVICES FOR FAMILIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21682 SHADYSPRING RD
CASTRO VALLEY CA
94546-6838
US

IV. Provider business mailing address

21682 SHADYSPRING RD
CASTRO VALLEY CA
94546-6838
US

V. Phone/Fax

Practice location:
  • Phone: 510-722-0749
  • Fax:
Mailing address:
  • Phone: 510-722-0749
  • Fax: 949-503-7463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: RAAJNA NAIDU
Title or Position: OWNER
Credential: BCBA
Phone: 510-722-0749