Provider Demographics
NPI:1700415239
Name:BADIE, SONYA KAY (RBT)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:KAY
Last Name:BADIE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1287 GWERDER ST
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-7944
Mailing Address - Country:US
Mailing Address - Phone:510-432-3752
Mailing Address - Fax:
Practice Address - Street 1:1287 GWERDER ST
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377-7944
Practice Address - Country:US
Practice Address - Phone:510-432-3752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-15-02768106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician