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Organization

OPEN SPECTRUM BEHAVIOR THERAPY

Active
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Organization

OPEN SPECTRUM BEHAVIOR THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BENJAMIN TUCKER M.S., LPCC, BCBA (OWNER)
(650) 208-8320
Entity
Organization

Contact information

Practice address
2625 ALCATRAZ AVE STE 609, BERKELEY, CA 94705
(650) 208-8320
Mailing address
2625 ALCATRAZ AVE STE 609, BERKELEY, CA 94705-2702

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PCC5297
CA
103K00000X
Behavior Analyst
Primary
1-11-9431

Other

Enumeration date
11/06/2017
Last updated
07/19/2018
About Stedi
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  • EDI platform