Healthcare Provider Details

I. General information

NPI: 1548783673
Provider Name (Legal Business Name): PRITI HOTPETI BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2017
Last Update Date: 07/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 UNIVERSITY AVE STE 201
SACRAMENTO CA
95825-6509
US

IV. Provider business mailing address

412 SEATON DR
FOLSOM CA
95630-7951
US

V. Phone/Fax

Practice location:
  • Phone: 916-448-2050
  • Fax:
Mailing address:
  • Phone: 916-276-8281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-17-26649
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: