Provider Demographics
NPI:1790143428
Name:WORM, ERIN RASHAAN (MA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:RASHAAN
Last Name:WORM
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 EMBARCADERO
Mailing Address - Street 2:SUITE 310
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-5231
Mailing Address - Country:US
Mailing Address - Phone:510-289-2470
Mailing Address - Fax:
Practice Address - Street 1:1900 EMBARCADERO
Practice Address - Street 2:SUITE 310
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-5231
Practice Address - Country:US
Practice Address - Phone:510-289-2470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-19785103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst