Individual
CARSON BAXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1811 GRAND CANAL BLVD STE 2, STOCKTON, CA 95207-8107
(877) 418-2978
Mailing address
1269 DAVID AVE, CONCORD, CA 94518-3835
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-39597
CA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/10/2018
Last updated
08/26/2021
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