Provider Demographics
NPI:1659177830
Name:TRANSFORMATIVE BEHAVIORAL CONSULTANTS, LLC
Entity type:Organization
Organization Name:TRANSFORMATIVE BEHAVIORAL CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:562-713-0401
Mailing Address - Street 1:2621 GREEN RIVER RD STE 105-2093
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-7433
Mailing Address - Country:US
Mailing Address - Phone:562-713-0401
Mailing Address - Fax:
Practice Address - Street 1:2621 GREEN RIVER RD STE 105-2093
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-7433
Practice Address - Country:US
Practice Address - Phone:562-713-0401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty