Healthcare Provider Details

I. General information

NPI: 1013464452
Provider Name (Legal Business Name): BEHAVIORAL & EDUCATIONAL STRATEGIES & TRAINING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2630 W RUMBLE RD
MODESTO CA
95350-0155
US

IV. Provider business mailing address

2630 W RUMBLE RD
MODESTO CA
95350-0155
US

V. Phone/Fax

Practice location:
  • Phone: 209-579-9444
  • Fax: 209-579-9494
Mailing address:
  • Phone: 209-579-9444
  • Fax: 209-579-9494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JEFF SALES
Title or Position: CONTROLLER
Credential:
Phone: 209-579-9444