Organization
BEHAVIORAL DIRECTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX CAMPBELL (PRESIDENT)
(415) 971-1186
Entity
Organization
Contact information
Practice address
131 ESMEYER DR, SAN RAFAEL, CA 94903-3770
(415) 971-1186
(415) 366-1685
Mailing address
131 ESMEYER DR, SAN RAFAEL, CA 94903-3770
(415) 971-1186
(415) 366-1685
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-08-4718
—
106H00000X
Marriage & Family Therapist
MFC30244
CA
Other
Enumeration date
11/01/2012
Last updated
11/01/2012
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