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General NPI Number Information
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NPI Number | 1770053191
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Entity Type | Individual
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Provider Name | AMY PROCTER MS, BCBA
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Gender | Female
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Dates
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Enumeration Date | 11/28/2018
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 591 WATT AVE STE 120
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City | SACRAMENTO
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State | CA
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Zip | 95864-5027
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Country | US
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Telephone | 916-448-2050
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Fax |
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Provider Business Mailing Address
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Address Line | 4350 AUBURN BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95841-4107
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Country | US
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Telephone |
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-18-71011
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License Number State | CA
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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 | 1-24-73203
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License Number State | CA
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