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General NPI Number Information
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NPI Number | 1871915678
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Entity Type | Organization
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Legal Business Name | CALIFORNIA AUTISM CENTER, INC.
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Dates
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Enumeration Date | 01/13/2014
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Last Update Date | 06/18/2021
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Provider Practice Location Address
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Address Line | 1630 W. SHAW AVE SUITE 190
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City | FRESNO
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State | CA
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Zip | 93710-8114
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Country | US
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Telephone | 559-492-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 5132 N PALM AVE BOX #303
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City | FRESNO
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State | CA
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Zip | 93704-2236
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Country | US
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Telephone | 559-385-5858
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICE
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Name | MR. WILLIAM FORATH
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Credential |
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Telephone | 559-492-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | CA
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