Individual
BENJAMIN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., LPCC, BCBA
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
(650) 208-8320
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PCC5297
CA
103K00000X
Behavior Analyst
Primary
1-11-9431
—
Other
Enumeration date
05/26/2012
Last updated
07/19/2018
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