Provider Demographics
NPI:1063846475
Name:MATL-BCBA
Entity Type:Organization
Organization Name:MATL-BCBA
Other - Org Name:ABA AND BEHAVIOR THERAPIES AND TESTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A T
Authorized Official - Last Name:LEHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:760-349-4200
Mailing Address - Street 1:11665 AVENA PL
Mailing Address - Street 2:STE 204
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2421
Mailing Address - Country:US
Mailing Address - Phone:760-349-4200
Mailing Address - Fax:760-349-4200
Practice Address - Street 1:361 LAMBERT GLN
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-2565
Practice Address - Country:US
Practice Address - Phone:760-349-4200
Practice Address - Fax:760-349-4200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-10-7411103K00000X, 103K00000X
NY000027103K00000X
251B00000X, 251C00000X, 251S00000X, 252Y00000X, 251B00000X, 251C00000X, 251S00000X, 252Y00000X
CA27844106H00000X
CA46706106H00000X
CA47132106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-10-7411OtherBACB
NY000027OtherLICENSED BEHAVIOR ANALYST