MEDICARE: NEDA EATON 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
1	103K00000X	Behavior Analyst	1-08-4741	CA

General Provider Information

NPI Number	:	1760729156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEDA EATON BCBA

Provider Business Mailing Address
First Line	:	554 RAMONA AVE
Second Line	:
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-2431
Country	:	US
Telephone Number	:	949-244-3798
Fax Number	:

Provider Business Practice Location Address
First Line	:	554 RAMONA AVE
Second Line	:
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-2431
Country	:	US
Telephone Number	:	949-244-3798
Fax Number	:

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

Provider Enumeration Date	:	01/07/2013
Last Update Date	:	03/26/2024

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