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General NPI Number Information
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NPI Number | 1588932412
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Entity Type | Organization
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Legal Business Name | PROOF POSITIVE ABA THERAPIES
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 3313 PARK DR
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City | SANTA ANA
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State | CA
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Zip | 92707-3850
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Country | US
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Telephone | 949-910-6767
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Fax |
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Provider Business Mailing Address
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Address Line | 3313 PARK DR
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City | SANTA ANA
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State | CA
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Zip | 92707-3850
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Country | US
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Telephone | 949-910-6767
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. HEATHER KRISTIN GRIMALDI
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Credential | M.S, BCBA
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Telephone | 949-246-9292
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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 | 1-11-8836
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License Number State | CA
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