Provider Demographics
NPI:1306224209
Name:SPRADER, ASHLEY A (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:SPRADER
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 MARINA AVE
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-9604
Mailing Address - Country:US
Mailing Address - Phone:925-413-8821
Mailing Address - Fax:
Practice Address - Street 1:3130 MARINA AVE
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-9604
Practice Address - Country:US
Practice Address - Phone:925-413-8821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-17360103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst