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General NPI Number Information
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NPI Number | 1053664466
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Entity Type | Individual
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Provider Name | SURABHI BAINS BCBA
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Gender | Female
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 38794 BUCKBOARD CMN
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City | FREMONT
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State | CA
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Zip | 94536-4263
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Country | US
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Telephone | 510-796-2686
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Fax |
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Provider Business Mailing Address
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Address Line | 38794 BUCKBOARD CMN
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City | FREMONT
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State | CA
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Zip | 94536-4263
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Country | US
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Telephone | 510-796-2686
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1119682
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License Number State | CA
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