Provider Demographics
NPI:1821639253
Name:MEINHOFER, IRA S (BCBA)
Entity type:Individual
Prefix:
First Name:IRA
Middle Name:S
Last Name:MEINHOFER
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 1:1440 COLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-3712
Mailing Address - Country:US
Mailing Address - Phone:916-724-9450
Mailing Address - Fax:
Practice Address - Street 1:1440 COLWOOD DR
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-3712
Practice Address - Country:US
Practice Address - Phone:916-724-9450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician