Provider Demographics
NPI:1255793626
Name:TSAI, EDWIN (MS, BCBA)
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:
Last Name:TSAI
Suffix:
Gender:M
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 1:9135 JUDICIAL DR APT 3209
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-4664
Mailing Address - Country:US
Mailing Address - Phone:626-617-9431
Mailing Address - Fax:
Practice Address - Street 1:2445 TRUXTUN RD STE 205
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-6154
Practice Address - Country:US
Practice Address - Phone:626-617-9431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-16-21742103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst