Provider Demographics
NPI:1841874443
Name:BERBER-RAMIREZ, BRIAN (BCBA)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:BERBER-RAMIREZ
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 1:2719 KEYSER DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-2865
Mailing Address - Country:US
Mailing Address - Phone:209-688-6996
Mailing Address - Fax:
Practice Address - Street 1:2027 GRAND CANAL BLVD STE 21
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6650
Practice Address - Country:US
Practice Address - Phone:209-570-4263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst