Healthcare Provider Details
I. General information
NPI: 1720435167
Provider Name (Legal Business Name): CLAYTON EARL BLAND JR. BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/16/2016
Last Update Date: 01/04/2026
Certification Date: 01/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3100 OAK RD STE 100
WALNUT CREEK CA
94597-2078
US
IV. Provider business mailing address
60B MOODY RD
BRUNSWICK ME
04011-7106
US
V. Phone/Fax
- Phone: 510-422-3959
- Fax:
- Phone: 207-680-4790
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: