Healthcare Provider Details

I. General information

NPI: 1316322944
Provider Name (Legal Business Name): KATIE DRYDEN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2015
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7525 N CEDAR AVE STE 101
FRESNO CA
93720-2689
US

IV. Provider business mailing address

7525 N CEDAR AVE STE 101
FRESNO CA
93720-2689
US

V. Phone/Fax

Practice location:
  • Phone: 888-988-0520
  • Fax:
Mailing address:
  • Phone: 888-988-0520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-17475
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: