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General NPI Number Information
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NPI Number | 1366840977
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Entity Type | Organization
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Legal Business Name | BRENDA MONTERDE BCBA AND ASSOCIATES INC
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Dates
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Enumeration Date | 12/12/2014
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 313 PLAZA DR BLDG A UNIT 5
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City | SANTA MARIA
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State | CA
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Zip | 93454-6931
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Country | US
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Telephone | 805-273-6556
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Fax | 844-884-4677
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Provider Business Mailing Address
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Address Line | 15315 MAGNOLIA BLVD STE 428
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1173
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Country | US
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Telephone | 888-603-7779
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Fax | 844-884-4677
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Authorized Official
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Title or Position | PRESIDENT/ DIRECTOR OF CLINICAL SER
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Name | MISS BRENDA PAOLA MONTERDE
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Credential | M.A BCBA
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Telephone | 818-406-2103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1-14-16087
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 1-14-16087
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 1-14-16087
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License Number State | CA
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