Provider Demographics
NPI:1720558414
Name:ALVEAR, SAVANNA GEORGIA (BCBA)
Entity Type:Individual
Prefix:
First Name:SAVANNA
Middle Name:GEORGIA
Last Name:ALVEAR
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 1:2400 LINCOLN OAK DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-9435
Mailing Address - Country:US
Mailing Address - Phone:559-512-2076
Mailing Address - Fax:559-272-0226
Practice Address - Street 1:2400 LINCOLN OAK DR
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-9435
Practice Address - Country:US
Practice Address - Phone:559-512-2076
Practice Address - Fax:559-272-0226
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2023-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
1-23-67434103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician