Provider Demographics
NPI:1558038950
Name:CONTARINO, NICHOLAS ANDREW (MS BCBA)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:ANDREW
Last Name:CONTARINO
Suffix:
Gender:M
Credentials:MS BCBA
Other - Prefix:
Other - First Name:NICK
Other - Middle Name:ANDREW
Other - Last Name:CONTARINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS BCBA
Mailing Address - Street 1:216 W ROBINSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-4020
Mailing Address - Country:US
Mailing Address - Phone:408-718-6336
Mailing Address - Fax:
Practice Address - Street 1:4141 STATE ST STE E-1213
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1814
Practice Address - Country:US
Practice Address - Phone:805-603-4968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst