Provider Demographics
NPI:1134627433
Name:FRANKLIN, NANCY JEANNE (MS, BCBA)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:JEANNE
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23441 MEADOW VIEW CT
Mailing Address - Street 2:
Mailing Address - City:BEAR VALLEY SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:93561-9295
Mailing Address - Country:US
Mailing Address - Phone:661-313-6075
Mailing Address - Fax:
Practice Address - Street 1:23441 MEADOW VIEW CT
Practice Address - Street 2:
Practice Address - City:BEAR VALLEY SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:93561-9295
Practice Address - Country:US
Practice Address - Phone:661-313-6075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-09-6649103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1-09-6649OtherBEHAVIOR ANALYST CERTIFICATION BOARD