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General NPI Number Information
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NPI Number | 1215894712
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Entity Type | Organization
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Legal Business Name | GENTLE BEHAVIOR RESOURCES
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 3243 SAN CARLOS DR
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City | SPRING VALLEY
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State | CA
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Zip | 91978-1059
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Country | US
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Telephone | 619-320-5235
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Fax | 619-599-8055
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Provider Business Mailing Address
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Address Line | 3243 SAN CARLOS DR
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City | SPRING VALLEY
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State | CA
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Zip | 91978-1059
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Country | US
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Telephone | 619-320-5235
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Fax | 619-599-8055
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARISSA AMAT-ROGERS
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Credential | MA BCBA
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Telephone | 619-320-5235
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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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