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General NPI Number Information
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NPI Number | 1366716920
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Entity Type | Individual
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Provider Name | METTE O MADSEN BCBA
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Gender | Female
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 1942 EMBARCADERO
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City | OAKLAND
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State | CA
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Zip | 94606-5213
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Country | US
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Telephone | 510-832-4383
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Fax | 510-550-1981
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Provider Business Mailing Address
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Address Line | 402 W BROADWAY STE 400
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City | SAN DIEGO
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State | CA
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Zip | 92101-3554
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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 |
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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 | 1-12-10105
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 104912
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License Number State | CA
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