MEDICARE: ADAPTIVE BEHAVIORAL SERVICES, LLC

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1205784352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAPTIVE BEHAVIORAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	2108 N ST STE N
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-5712
Country	:	US
Telephone Number	:	707-316-4636
Fax Number	:

Provider Business Practice Location Address
First Line	:	3369 MITCHELL HEIGHTS DR
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95503-9732
Country	:	US
Telephone Number	:	707-316-4636
Fax Number	:

Authorized Official
Title or Position	:	BOARD CERTIFIED BEHAVIOR ANALYST
Name	:	AMY PROCTER
Credential	:	M.S.
Telephone Number	:	707-316-4636

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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