Provider Demographics
NPI:1477878346
Name:MAYER, GEORGE MAYER (EDD, BCBA)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:MAYER
Last Name:MAYER
Suffix:
Gender:M
Credentials:EDD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10735 FRANK DANIELS WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-2633
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10735 FRANK DANIELS WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-2633
Practice Address - Country:US
Practice Address - Phone:858-549-1478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-99-0151OtherBEHAVIOR ANALYSIS CERTIFICATION BOARD (BACB) INTERNATIONAL