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General NPI Number Information
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NPI Number | 1053038372
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Entity Type | Organization
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Legal Business Name | POSITIVE BEHAVIOR SUPPORT CORP.
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 1101 EUCALYPTUS DR
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-1401
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Country | US
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Telephone | 510-695-1508
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Fax |
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Provider Business Mailing Address
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Address Line | 76 SUMMIT WAY
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-2996
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Country | US
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Telephone | 510-695-1508
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Fax |
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Authorized Official
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Title or Position | BEHAVIOR ASSISTANT
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Name | KYLE L PULIDO
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Credential |
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Telephone | 510-695-1508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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