Provider Demographics
NPI:1245753748
Name:BAY AREA BEHAVIOR CONSULTANTS
Entity Type:Organization
Organization Name:BAY AREA BEHAVIOR CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO OF MED SRVS & RELATED SUPPORT
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:MESA
Authorized Official - Suffix:
Authorized Official - Credentials:MS,MA,LBA,BCBA,BICM,
Authorized Official - Phone:917-862-2250
Mailing Address - Street 1:5409 ACE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94806-5885
Mailing Address - Country:US
Mailing Address - Phone:510-313-8268
Mailing Address - Fax:
Practice Address - Street 1:5409 ACE CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-5885
Practice Address - Country:US
Practice Address - Phone:510-313-8268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty