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NPI Code Detail

MEDICARE: MISS TAMARRA DIANE DANIELS BCBA

MEDICARE: MISS TAMARRA DIANE DANIELS 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 Analyst1-21-53541CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11-21-53541OTHERCABEHAVIOR ANALYST CERTIFICATION BOARD (BACB)

General Provider Information

NPI Number : 1912405093
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TAMARRA DIANE DANIELS BCBA
Provider Business Mailing Address
First Line : 21600 OXNARD ST
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-4976
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 5168 N BLYTHE AVE STE 102
Second Line :
City : FRESNO
State : CA
Zip : 93722-6478
Country : US
Telephone Number : 559-255-5900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2018
Last Update Date : 11/05/2021

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