Healthcare Provider Details

I. General information

NPI: 1205784352
Provider Name (Legal Business Name): ADAPTIVE BEHAVIORAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3369 MITCHELL HEIGHTS DR
EUREKA CA
95503-9732
US

IV. Provider business mailing address

2108 N ST STE N
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 707-316-4636
  • Fax:
Mailing address:
  • Phone: 707-316-4636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AMY PROCTER
Title or Position: BOARD CERTIFIED BEHAVIOR ANALYST
Credential: M.S.
Phone: 707-316-4636