Provider Demographics
NPI:1316303126
Name:TUCKER, MARALINA (MA, BCBA)
Entity type:Individual
Prefix:
First Name:MARALINA
Middle Name:
Last Name:TUCKER
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-7029
Mailing Address - Country:US
Mailing Address - Phone:661-843-1930
Mailing Address - Fax:661-843-1929
Practice Address - Street 1:4500 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7029
Practice Address - Country:US
Practice Address - Phone:661-843-1930
Practice Address - Fax:661-843-1929
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-20734103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst