Provider Demographics
NPI:1073814802
Name:CHAVEZ, BRANDI (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:BYKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11535 AVENUE 264
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-9315
Mailing Address - Country:US
Mailing Address - Phone:559-747-3894
Mailing Address - Fax:559-747-3642
Practice Address - Street 1:11535 AVENUE 264
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-9315
Practice Address - Country:US
Practice Address - Phone:559-747-3894
Practice Address - Fax:559-747-3642
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA1-18-31538103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor