Provider Demographics
NPI:1699018804
Name:MCCRARY, KAREN (BCBA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MCCRARY
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 1:229 NEWBURY WAY
Mailing Address - Street 2:
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-4228
Mailing Address - Country:US
Mailing Address - Phone:707-246-7920
Mailing Address - Fax:707-648-0393
Practice Address - Street 1:229 NEWBURY WAY
Practice Address - Street 2:
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-4228
Practice Address - Country:US
Practice Address - Phone:707-246-7920
Practice Address - Fax:707-648-0393
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-13-12853103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst