| Open Spectrum Behavior Therapy | |
|
2625 Alcatraz Ave Ste 609 Berkeley CA 94705 | |
| (650) 208-8320 | |
| Not Available |
| Full Name | Open Spectrum Behavior Therapy |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2625 Alcatraz Ave Ste 609, Berkeley, California |
| Authorized Official Name and Position | Benjamin Tucker (OWNER) |
| Authorized Official Contact | 6502088320 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Spectrum Behavior Therapy 2625 Alcatraz Ave Ste 609 Berkeley CA 94705-2702 | Open Spectrum Behavior Therapy 2625 Alcatraz Ave Ste 609 Berkeley CA 94705 Ph: (650) 208-8320 |
| NPI Number | 1265945844 |
|---|---|
| Provider Enumeration Date | 11/06/2017 |
| Last Update Date | 07/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265945844 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | PCC5297 (California) | Secondary |
| 103K00000X | Behavior Analyst | 1-11-9431 () | Primary |
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