Provider Demographics
NPI:1700324555
Name:SACRAMENTO AUTISM SERVICES
Entity Type:Organization
Organization Name:SACRAMENTO AUTISM SERVICES
Other - Org Name:BITS BEHAVIOR INTERVENTION TECHNOLOGY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:916-897-7653
Mailing Address - Street 1:7840 MADISON AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3589
Mailing Address - Country:US
Mailing Address - Phone:916-534-7572
Mailing Address - Fax:
Practice Address - Street 1:7840 MADISON AVE STE 150
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3589
Practice Address - Country:US
Practice Address - Phone:916-534-7572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1151992103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1151992OtherBCBA
CA566667OtherGROUP NUMBER
CA=========OtherEIN