Provider Demographics
NPI:1942661681
Name:HOMME, DEVON (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:HOMME
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:PO BOX 1408
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361-1408
Mailing Address - Country:US
Mailing Address - Phone:209-993-1829
Mailing Address - Fax:
Practice Address - Street 1:16925 SCHELL RD
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-8705
Practice Address - Country:US
Practice Address - Phone:209-993-1829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-10-7005103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst