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General NPI Number Information
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NPI Number | 1700183803
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Entity Type | Organization
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Legal Business Name | CENTRAL VALLEY AUTISM PROJECT, INC.
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 5501 ANTIQUE ROSE WAY
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City | RIVERBANK
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State | CA
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Zip | 95367-9505
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Country | US
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Telephone | 209-521-4791
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Fax | 209-521-4794
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Provider Business Mailing Address
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Address Line | PO BOX 399318
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City | SAN FRANCISCO
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State | CA
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Zip | 94139-9318
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Country | US
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Telephone | 623-444-2169
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Fax |
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | TORI BEJAR
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Credential |
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Telephone | 623-444-2169
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-00-0243
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License Number State | CA
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