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General NPI Number Information
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NPI Number | 1700249836
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Entity Type | Organization
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Legal Business Name | AUTISM DEAF EMPOWERMENT ADVOCACY FOUNDATION INC
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Dates
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Enumeration Date | 04/05/2016
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 12850 EXCALIBUR DR
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City | CORONA
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State | CA
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Zip | 92880-3640
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Country | US
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Telephone | 682-434-6539
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Fax |
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Provider Business Mailing Address
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Address Line | 8287 WHITE OAK AVE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-7671
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Country | US
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Telephone | 682-434-6539
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. DELORES JOHNSON
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Credential |
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Telephone | 951-591-9211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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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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