Provider Demographics
NPI:1093193328
Name:CARDER, HEATHER (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:CARDER
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:CARDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:8539 N BARTON AVE # 1000
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1983
Mailing Address - Country:US
Mailing Address - Phone:559-649-3606
Mailing Address - Fax:
Practice Address - Street 1:1200 CONCORD AVE STE 100
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4969
Practice Address - Country:US
Practice Address - Phone:510-268-8120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-18137103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1-15-18137OtherBCBA