Provider Demographics
NPI:1235472051
Name:BYRNE, PAULA (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:
Last Name:BYRNE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:778 OLIVE CT
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-3354
Mailing Address - Country:US
Mailing Address - Phone:650-921-4559
Mailing Address - Fax:
Practice Address - Street 1:778 OLIVE CT
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-3354
Practice Address - Country:US
Practice Address - Phone:650-921-4559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-12-11802103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst