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NPI Code Detail

MEDICARE: ADVANCEMENT FOR BEHAVIORAL & EDUCATIONAL DEVELOPMENT & INTERVENTION

MEDICARE: ADVANCEMENT FOR BEHAVIORAL & EDUCATIONAL DEVELOPMENT & INTERVENTION
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
1106H00000XMarriage & Family Therapist4039CA
2103K00000XBehavior Analyst1-04-1559CA

General Provider Information

NPI Number : 1144598467
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCEMENT FOR BEHAVIORAL & EDUCATIONAL DEVELOPMENT & INTERVENTION
Provider Business Mailing Address
First Line : 315 CENTENNIAL WAY
Second Line :
City : TUSTIN
State : CA
Zip : 92780-3714
Country : US
Telephone Number : 949-250-1101
Fax Number : 949-250-1103
Provider Business Practice Location Address
First Line : 315 CENTENNIAL WAY
Second Line :
City : TUSTIN
State : CA
Zip : 92780-3714
Country : US
Telephone Number : 949-250-1101
Fax Number : 949-250-1103
Authorized Official
Title or Position : MANAGER OF ADMINISTRATIVE SERVICES
Name : RHONDA MARIE RIVAS
Credential :
Telephone Number : 949-250-1101
Provider Enumeration Date : 12/01/2011
Last Update Date : 10/02/2019

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Directions to “ADVANCEMENT FOR BEHAVIORAL & EDUCATIONAL DEVELOPMENT & INTERVENTION ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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