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NPI Code Detail

MEDICARE: DEBORAH SANDERS M.ED., BCBA

MEDICARE: DEBORAH SANDERS M.ED., 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 AnalystBCBA 1-14-17731CA

General Provider Information

NPI Number : 1508233388
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH SANDERS M.ED., BCBA
Provider Business Mailing Address
First Line : 154 PASEO DE LA CONCHA
Second Line : APT. D
City : REDONDO BEACH
State : CA
Zip : 90277-6247
Country : US
Telephone Number : 310-994-8969
Fax Number :
Provider Business Practice Location Address
First Line : 1230 ROSECRANS AVE STE 250
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-2496
Country : US
Telephone Number : 310-406-1500
Fax Number : 310-406-1500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2015
Last Update Date : 08/27/2015

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