Healthcare Provider Details

I. General information

NPI: 1972422954
Provider Name (Legal Business Name): BEHAVIOR FRONTIERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 PLAZA DR STE 100
ROCKLIN CA
95765-4419
US

IV. Provider business mailing address

5623 RIDGEPOINT DR
ANTELOPE CA
95843-3738
US

V. Phone/Fax

Practice location:
  • Phone: 916-304-9661
  • Fax: 855-568-2494
Mailing address:
  • Phone: 916-261-9322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: PAIGE E SHADINGER
Title or Position: BEHAVIORAL TECH
Credential:
Phone: 916-261-9322