Provider Demographics
NPI:1205386646
Name:BEHAVIOR MATTERS CALIFORNIA LLC
Entity Type:Organization
Organization Name:BEHAVIOR MATTERS CALIFORNIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REBEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDGE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA, LBA
Authorized Official - Phone:907-726-5330
Mailing Address - Street 1:16941 N EAGLE RIVER LOOP RD STE 3
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7802
Mailing Address - Country:US
Mailing Address - Phone:907-726-5330
Mailing Address - Fax:907-726-5366
Practice Address - Street 1:2401 WATERMAN BLVD
Practice Address - Street 2:STE 4A-208
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-1800
Practice Address - Country:US
Practice Address - Phone:907-726-5330
Practice Address - Fax:907-726-5366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty