Provider Demographics
NPI:1760755482
Name:FICCAGLIA, MICHELLE BETH (PHD BCBA)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:BETH
Last Name:FICCAGLIA
Suffix:
Gender:F
Credentials:PHD BCBA
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1764 MARCO POLO WAY
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-4503
Mailing Address - Country:US
Mailing Address - Phone:650-259-8500
Mailing Address - Fax:
Practice Address - Street 1:1764 MARCO POLO WAY
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4503
Practice Address - Country:US
Practice Address - Phone:650-259-8500
Practice Address - Fax:650-259-0188
Is Sole Proprietor?:No
Enumeration Date:2012-02-10
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst