Provider Demographics
NPI:1821462235
Name:DAVIS, BRITTANY (BCBA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:DAVIS
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 1:916 OBISPO AVE
Mailing Address - Street 2:APT. 5
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-5080
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:916 OBISPO AVE
Practice Address - Street 2:APT. 5
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-5080
Practice Address - Country:US
Practice Address - Phone:562-400-7061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-18632103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst