Provider Demographics
NPI:1285494427
Name:AMAZE BEHAVIOR CONSULTANTS, LLC
Entity type:Organization
Organization Name:AMAZE BEHAVIOR CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:OROZCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-294-9525
Mailing Address - Street 1:564 CAPE BRETON LN
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-6641
Mailing Address - Country:US
Mailing Address - Phone:510-294-9525
Mailing Address - Fax:
Practice Address - Street 1:1515 AURORA DRIVE
Practice Address - Street 2:SUITE 103D PMB 1021
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577
Practice Address - Country:US
Practice Address - Phone:510-294-9525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-21
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health