Individual
MRS. BREANNA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
9355 W STOCKTON BLVD, UNIT 100, ELK GROVE, CA 95758
(916) 683-1109
Mailing address
9355 W STOCKTON BLVD, UNIT 100, ELK GROVE, CA 95624
(916) 683-1109
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-62349
CA
106E00000X
Assistant Behavior Analyst
0-22-13473
CA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
11/26/2018
Last updated
11/01/2022
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