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General NPI Number Information
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NPI Number | 1982578548
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Entity Type | Organization
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Legal Business Name | RISING STAR SPED ACADEMY- STELLAR
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 2400 FLINT AVE
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City | SAN JOSE
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State | CA
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Zip | 95148-1719
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Country | US
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Telephone | 510-557-0562
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 FLINT AVE
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City | SAN JOSE
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State | CA
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Zip | 95148-1719
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Country | US
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Telephone | 510-557-0562
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BEHAVIORAL SERVICES
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Name | NIJETHA BASKAR
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Credential |
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Telephone | 818-439-7613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 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 #3
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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 #4
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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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