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General NPI Number Information
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NPI Number | 1235662107
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Entity Type | Individual
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Provider Name | JOSEPH STEPHEN COUNIHAN BCBA
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Gender | Male
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 04/07/2017
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Provider Practice Location Address
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Address Line | 5820 STONERIDGE MALL RD 205
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City | PLEASANTON
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State | CA
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Zip | 94588-3274
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Country | US
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Telephone | 925-329-8964
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Fax |
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Provider Business Mailing Address
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Address Line | 269 CAMPBELL AVE
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City | VALLEJO
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State | CA
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Zip | 94590-7103
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Country | US
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Telephone | 925-329-8954
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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 | 1-17-25630
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License Number State | CA
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