Healthcare Provider Details

I. General information

NPI: 1710768437
Provider Name (Legal Business Name): IMPROVING HABITS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 HANOVER AVE APT 307
OAKLAND CA
94606-5603
US

IV. Provider business mailing address

365 HANOVER AVE APT 307
OAKLAND CA
94606-5603
US

V. Phone/Fax

Practice location:
  • Phone: 831-708-9550
  • Fax:
Mailing address:
  • Phone: 831-708-9550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: POLINA LYANDRES
Title or Position: CEO
Credential: MA, BCBA
Phone: 831-708-9550