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General NPI Number Information
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NPI Number | 1811550007
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Entity Type | Organization
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Legal Business Name | CLINICAL BEHAVIOR LLC
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 1750 PRAIRIE CITY RD STE 113-1114
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City | FOLSOM
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State | CA
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Zip | 95630-9595
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Country | US
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Telephone | 424-248-8641
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Fax |
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Provider Business Mailing Address
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Address Line | 1750 PRAIRIE CITY RD STE 113-1114
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City | FOLSOM
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State | CA
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Zip | 95630-9595
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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 | ADMINISTRATIVE SUPPORT
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Name | ROSA JOHNSON
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Credential |
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Telephone | 424-248-8641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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