Provider Demographics
NPI:1801289186
Name:FRAISER, SAOIRSE HEATHER (BCBA)
Entity type:Individual
Prefix:
First Name:SAOIRSE
Middle Name:HEATHER
Last Name:FRAISER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 SPRING MOUNTAIN LN
Mailing Address - Street 2:
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-3935
Mailing Address - Country:US
Mailing Address - Phone:408-348-0597
Mailing Address - Fax:
Practice Address - Street 1:803 SPRING MOUNTAIN LN
Practice Address - Street 2:
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-3935
Practice Address - Country:US
Practice Address - Phone:408-348-0597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-9435103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst