Provider Demographics
NPI:1154871689
Name:SMITH, AMANDA JOY (BCBA)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JOY
Last Name:SMITH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:JOY
Other - Last Name:BEHME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2977 HENRYS FORK DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-5207
Mailing Address - Country:US
Mailing Address - Phone:925-586-3073
Mailing Address - Fax:
Practice Address - Street 1:1400 OREGON ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1620
Practice Address - Country:US
Practice Address - Phone:530-232-0525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-07
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-13-14309103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst