Provider Demographics
NPI:1265995435
Name:COLLABORATIVE AUTISM MANAGEMENT PROGRAMS INC.
Entity type:Organization
Organization Name:COLLABORATIVE AUTISM MANAGEMENT PROGRAMS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CAMP
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:760-217-9678
Mailing Address - Street 1:9360 SANTA ANITA AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6151
Mailing Address - Country:US
Mailing Address - Phone:909-481-2080
Mailing Address - Fax:909-277-7882
Practice Address - Street 1:9360 SANTA ANITA AVE STE 104
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730
Practice Address - Country:US
Practice Address - Phone:909-481-2080
Practice Address - Fax:909-277-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1427485366OtherNPI