MEDICARE: CHRISTINA FALLS BCBA, MS

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	11313980	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1831459742	OTHER	CA	LEARNING SOLUTIONS KIDS

General Provider Information

NPI Number	:	1598167637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA FALLS BCBA, MS

Provider Business Mailing Address
First Line	:	3031 C ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-3326
Country	:	US
Telephone Number	:	916-442-2396
Fax Number	:	916-442-2525

Provider Business Practice Location Address
First Line	:	3031 C ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-3326
Country	:	US
Telephone Number	:	916-442-2396
Fax Number	:	916-442-2525

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2014
Last Update Date	:	09/19/2014

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