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NPI Code Detail

MEDICARE: GENTLE BEHAVIOR RESOURCES

MEDICARE: GENTLE BEHAVIOR RESOURCES
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 Analyst

General Provider Information

NPI Number : 1215894712
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENTLE BEHAVIOR RESOURCES
Provider Business Mailing Address
First Line : 3243 SAN CARLOS DR
Second Line :
City : SPRING VALLEY
State : CA
Zip : 91978-1059
Country : US
Telephone Number : 619-320-5235
Fax Number : 619-599-8055
Provider Business Practice Location Address
First Line : 3243 SAN CARLOS DR
Second Line :
City : SPRING VALLEY
State : CA
Zip : 91978-1059
Country : US
Telephone Number : 619-320-5235
Fax Number : 619-599-8055
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MARISSA AMAT-ROGERS
Credential : MA BCBA
Telephone Number : 619-320-5235
Provider Enumeration Date : 01/06/2026
Last Update Date : 01/06/2026

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Directions to “GENTLE BEHAVIOR RESOURCES ” Practice Location

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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.