Provider Demographics
NPI:1114310950
Name:DENEVI, DENISE (MS BCBA)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:DENEVI
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 CENTURY WAY
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-5334
Mailing Address - Country:US
Mailing Address - Phone:402-613-6141
Mailing Address - Fax:
Practice Address - Street 1:6116 CHELTON DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2429
Practice Address - Country:US
Practice Address - Phone:510-493-0855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-14-10374103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst