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General NPI Number Information
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NPI Number | 1558225896
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Entity Type | Organization
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Legal Business Name | BEHAVIOR LEARNING AND DEVELOPMENT GROUP, LLC
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 1906 VISTA DEL LAGO DR STE I
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City | VALLEY SPRINGS
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State | CA
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Zip | 95252-9700
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Country | US
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Telephone | 209-268-0868
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Fax | 209-254-7900
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Provider Business Mailing Address
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Address Line | PO BOX 279
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City | MOUNTAIN RANCH
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State | CA
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Zip | 95246-0279
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Country | US
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Telephone | 209-268-0868
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Fax | 209-254-7900
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Authorized Official
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Title or Position | CO-OWNER
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Name | THERESA MARIE BENAVIDEZ
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Credential | BCBA
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Telephone | 915-249-0365
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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 |
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License Number State |
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