Healthcare Provider Details

I. General information

NPI: 1225676125
Provider Name (Legal Business Name): HANNAH ACEVEDO-SCHIESEL LEP, BCBA, ABSNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2019
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4329 PIEDMONT AVE
OAKLAND CA
94611-4715
US

IV. Provider business mailing address

4329 PIEDMONT AVE
OAKLAND CA
94611-4715
US

V. Phone/Fax

Practice location:
  • Phone: 510-730-1537
  • Fax:
Mailing address:
  • Phone: 510-730-1537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number3089
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-04-1575
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: