Healthcare Provider Details

I. General information

NPI: 1699187062
Provider Name (Legal Business Name): ANGELA HAYDEL BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CONCORD AVE STE 185
CONCORD CA
94520-5006
US

IV. Provider business mailing address

798 LIGHTHOUSE AVE # 324
MONTEREY CA
93940-1010
US

V. Phone/Fax

Practice location:
  • Phone: 510-268-8120
  • Fax:
Mailing address:
  • Phone: 855-832-6727
  • Fax: 772-675-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-15353
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: