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General NPI Number Information
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NPI Number | 1265883367
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Entity Type | Organization
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Legal Business Name | CHANGE WITH ABA
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 1259 SUNNY CT #4
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City | SAN JOSE
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State | CA
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Zip | 95116-2863
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Country | US
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Telephone | 818-585-8061
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Fax |
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Provider Business Mailing Address
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Address Line | 1259 SUNNY CT #4
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City | SAN JOSE
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State | CA
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Zip | 95116-2863
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO - CLINICAL DIRECTOR
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Name | MISS POOJA CHOPRA
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Credential | M.S BCBA
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Telephone | 818-585-8061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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