Provider Demographics
NPI:1417317314
Name:PAULSEN, ERIN (BCBA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:PAULSEN
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 1:5048 N JACKSON AVE
Mailing Address - Street 2:MAIL STOP LS138
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93740-0001
Mailing Address - Country:US
Mailing Address - Phone:559-278-6773
Mailing Address - Fax:
Practice Address - Street 1:5048 N JACKSON AVE
Practice Address - Street 2:MAIL STOP LS138
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93740-0001
Practice Address - Country:US
Practice Address - Phone:559-278-6773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-18847103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst