MEDICARE: DAMIEN ALDER

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	F3312850	CA

General Provider Information

NPI Number	:	1700675550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAMIEN ALDER

Provider Business Mailing Address
First Line	:	2001 ALLSTON WAY
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94704-1496
Country	:	US
Telephone Number	:	510-575-6488
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 ALLSTON WAY
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94704-1496
Country	:	US
Telephone Number	:	510-575-6488
Fax Number	:

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

Provider Enumeration Date	:	05/06/2025
Last Update Date	:	12/02/2025

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