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General NPI Number Information
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NPI Number | 1477096261
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Entity Type | Individual
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Provider Name | JOHN DENIZIO BCBA
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Gender | Male
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Dates
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Enumeration Date | 11/28/2016
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Last Update Date | 11/28/2016
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Provider Practice Location Address
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Address Line | 730 7TH ST STE A
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City | EUREKA
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State | CA
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Zip | 95501-1178
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Country | US
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Telephone | 818-241-6780
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Fax | 818-241-6853
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Provider Business Mailing Address
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Address Line | 505 N BRAND BLVD STE 1000
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City | GLENDALE
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State | CA
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Zip | 91203-3924
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Country | US
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Telephone | 818-241-6780
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Fax | 818-241-6853
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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 | 1-16-22979
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License Number State | CA
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