Healthcare Provider Details

I. General information

NPI: 1184114308
Provider Name (Legal Business Name): ARTHUR ROBERT ANDERSON M.ED., BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2018
Last Update Date: 01/08/2021
Certification Date: 01/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 E MCKINLEY AVE
FRESNO CA
93728-1729
US

IV. Provider business mailing address

605 E MCKINLEY AVE
FRESNO CA
93728-1729
US

V. Phone/Fax

Practice location:
  • Phone: 408-505-9727
  • Fax:
Mailing address:
  • Phone: 408-505-9727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-46529
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: