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General NPI Number Information
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NPI Number | 1922947647
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Entity Type | Organization
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Legal Business Name | MINDBRIDGEABA
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 141 N K ST
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City | TULARE
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State | CA
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Zip | 93274-4003
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Country | US
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Telephone | 559-885-3926
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Fax | 559-885-3926
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Provider Business Mailing Address
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Address Line | 141 N K ST
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City | TULARE
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State | CA
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Zip | 93274-4003
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Country | US
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Telephone | 559-754-3011
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | EUNICE BOBO
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Credential | APCC
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Telephone | 559-885-3926
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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 |
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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 |
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License Number State |
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