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NPI Code Detail

MEDICARE: KRISTEN SILLIMAN M.A., BCBA

MEDICARE:   KRISTEN  SILLIMAN  M.A., 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 Analyst1-10-7485FL

General Provider Information

NPI Number : 1821389156
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN SILLIMAN M.A., BCBA
Provider Business Mailing Address
First Line : 4540 HARLIN DR
Second Line :
City : SACRAMENTO
State : CA
Zip : 95826-9716
Country : US
Telephone Number : 916-364-7800
Fax Number :
Provider Business Practice Location Address
First Line : 4540 HARLIN DR
Second Line :
City : SACRAMENTO
State : CA
Zip : 95826-9716
Country : US
Telephone Number : 916-364-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2011
Last Update Date : 04/20/2011

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Directions to “ KRISTEN SILLIMAN M.A., BCBA” Practice Location

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