Provider Demographics
NPI:1083189237
Name:BAHLS, CHRISTINA LAURA (BCBA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LAURA
Last Name:BAHLS
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 1:2 CROW CANYON CT STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1681
Mailing Address - Country:US
Mailing Address - Phone:925-232-1043
Mailing Address - Fax:
Practice Address - Street 1:2 CROW CANYON CT STE 110
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1681
Practice Address - Country:US
Practice Address - Phone:925-232-1043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-25-83293103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst