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NPI Code Detail

MEDICARE: MS. GLADYS CHAN BCBA

MEDICARE: MS. GLADYS CHAN BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst11211765

General Provider Information

NPI Number : 1013342096
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GLADYS CHAN BCBA
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number : 866-832-6727
Fax Number : 772-675-9100
Provider Business Practice Location Address
First Line : 2010 CROW CANYON PL STE 100
Second Line :
City : SAN RAMON
State : CA
Zip : 94583-1344
Country : US
Telephone Number : 855-832-6727
Fax Number : 772-675-9100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2013
Last Update Date : 07/14/2021

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Directions to “ MS. GLADYS CHAN BCBA” Practice Location

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