Healthcare Provider Details

I. General information

NPI: 1245630789
Provider Name (Legal Business Name): ADAM D PRICE MA, BCBA 1-14-15803
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2014
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

581 SHAYS WAY
RAMONA CA
92065-1963
US

IV. Provider business mailing address

14504 JANAL WAY
SAN DIEGO CA
92129-1628
US

V. Phone/Fax

Practice location:
  • Phone: 760-466-8036
  • Fax:
Mailing address:
  • Phone: 916-218-9652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: