Provider Demographics
NPI:1700305497
Name:CHEGE, JAMES M (BCBA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:CHEGE
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37847 NILES BLVD APT 2
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-2943
Mailing Address - Country:US
Mailing Address - Phone:510-470-8040
Mailing Address - Fax:
Practice Address - Street 1:3031 TISCH WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2541
Practice Address - Country:US
Practice Address - Phone:408-416-7536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CA12258117103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician