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General NPI Number Information
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NPI Number | 1992211379
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Entity Type | Individual
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Provider Name | TYNE ALUCIA WILLIAMS BCABA
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Gender | Female
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Dates
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Enumeration Date | 12/20/2017
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 700 N ESTRELLA PKWY STE 215&230
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City | GOODYEAR
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State | AZ
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Zip | 85338-9271
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Country | US
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Telephone | 628-833-8424
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Fax |
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Provider Business Mailing Address
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Address Line | 3030 CALLE FRONTERA
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-3009
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Country | US
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Telephone | 949-272-6146
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Fax | 888-847-8864
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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-17-38132
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License Number State | CA
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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 | 02515825
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License Number State | AZ
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