Healthcare Provider Details

I. General information

NPI: 1164830022
Provider Name (Legal Business Name): TARYN WRIGHT-FONG M.A., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 CROW CANYON PL
SAN RAMON CA
94583-4634
US

IV. Provider business mailing address

95 3RD ST FL 2
SAN FRANCISCO CA
94103-3103
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax: 772-675-9100
Mailing address:
  • Phone: 415-813-2204
  • Fax: 177-267-5910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number11416664
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: