Provider Demographics
NPI:1851042956
Name:DE WITT AND ASSOCIATES BEHAVIOR SERVICES INC
Entity Type:Organization
Organization Name:DE WITT AND ASSOCIATES BEHAVIOR SERVICES INC
Other - Org Name:DABS INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUVENCIO
Authorized Official - Middle Name:
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-558-8786
Mailing Address - Street 1:2801 PINOLE VALLEY RD STE 208
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-1464
Mailing Address - Country:US
Mailing Address - Phone:510-558-8786
Mailing Address - Fax:
Practice Address - Street 1:2801 PINOLE VALLEY RD STE 208
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-1464
Practice Address - Country:US
Practice Address - Phone:510-558-8786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty