Healthcare Provider Details

I. General information

NPI: 1205799178
Provider Name (Legal Business Name): CREATIVE MINDS ABA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2025
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 CARBURY WAY
ROSEVILLE CA
95747-7036
US

IV. Provider business mailing address

1515 CARBURY WAY
ROSEVILLE CA
95747-7036
US

V. Phone/Fax

Practice location:
  • Phone: 916-472-8474
  • Fax:
Mailing address:
  • Phone: 916-472-8474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: BIRINDER AUJLA
Title or Position: BEHAVIOR ANALYST
Credential: BCBA
Phone: 916-472-8474