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General NPI Number Information
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NPI Number | 1114535382
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Entity Type | Organization
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Legal Business Name | BADONI BEHAVIORAL SERVICES LLC
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 3031 TISCH WAY
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City | SAN JOSE
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State | CA
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Zip | 95128-2541
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Country | US
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Telephone | 408-416-7539
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Fax | 408-413-4448
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Provider Business Mailing Address
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Address Line | 6699 BOGIALA WAY
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City | GILROY
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State | CA
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Zip | 95020-7108
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Country | US
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Telephone | 408-416-7539
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Fax | 408-413-4448
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Authorized Official
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Title or Position | OWNER
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Name | PARVATI BADONI
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Credential | BCBA
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Telephone | 408-416-7539
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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 |
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License Number State |
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