MEDICARE: TEACH AND PLAY ABA INC

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

General Provider Information

NPI Number	:	1992544092
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEACH AND PLAY ABA INC

Provider Business Mailing Address
First Line	:	9528 MIRAMAR RD # 1072
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-4533
Country	:	US
Telephone Number	:	217-769-1551
Fax Number	:	858-377-5462

Provider Business Practice Location Address
First Line	:	845 15TH ST STE 407A
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-8098
Country	:	US
Telephone Number	:	217-769-1551
Fax Number	:	858-377-5462

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	SARA ALLYN SHRIVASTAV
Credential	:	BCBA
Telephone Number	:	217-769-1551

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	06/13/2024

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Directions to “TEACH AND PLAY ABA INC ” Practice Location

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