Basic Information
| Provider Information | |||||||||
| NPI: | 1528382181 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AUTISM BEHAVIOR SERVICES INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2080 N TUSTIN AVE | ||||||||
| Address2: | SUITE B | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927057875 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7147175156 | ||||||||
| FaxNumber: | 9497090311 | ||||||||
| Practice Location | |||||||||
| Address1: | 2080 N TUSTIN AVE | ||||||||
| Address2: | SUITE B | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927057875 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7147175156 | ||||||||
| FaxNumber: | 9497090311 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2010 | ||||||||
| LastUpdateDate: | 02/18/2016 | ||||||||
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| AuthorizedOfficialLastName: | PATTERSON | ||||||||
| AuthorizedOfficialFirstName: | ROSA | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7147175156 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | BCBA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 1-09-5367 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.