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General NPI Number Information
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NPI Number | 1144941162
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Entity Type | Individual
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Provider Name | ANNELIES TOBDZIC BCBA
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Gender | Female
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Dates
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Enumeration Date | 09/07/2022
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 2000 POWELL ST STE 900
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City | EMERYVILLE
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State | CA
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Zip | 94608-1888
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Country | US
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Telephone | 510-542-5775
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Fax |
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Provider Business Mailing Address
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Address Line | 915 TREBBIANO CT
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City | DANVILLE
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State | CA
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Zip | 94506-2099
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Country | US
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Telephone | 201-675-2220
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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 | 1-21-56545
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License Number State |
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