Organization
CREATIVE BEHAVIOR INTERVENTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENISE MARIE ECKMAN PSY.D., BCBA-D (PRESIDENT)
(949) 861-1580
Entity
Organization
Contact information
Practice address
3002 DOW AVE, SUITE 520, TUSTIN, CA 92780-7233
(949) 861-1580
(949) 328-7689
Mailing address
3002 DOW AVE, SUITE 520, TUSTIN, CA 92780-7233
(949) 861-1580
(949) 328-7689
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-07-3777
CA
103TB0200X
Cognitive & Behavioral Psychologist
PSY22024
CA
251C00000X
Developmentally Disabled Services Day Training Agency
1-07-3777
CA
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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