Provider Demographics
NPI:1366799066
Name:HANSON, ROBBIE (BCBA)
Entity type:Individual
Prefix:
First Name:ROBBIE
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10055 SHADY VIEW CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-2734
Mailing Address - Country:US
Mailing Address - Phone:916-494-3703
Mailing Address - Fax:
Practice Address - Street 1:140 W FRANKLIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2725
Practice Address - Country:US
Practice Address - Phone:800-991-6070
Practice Address - Fax:800-991-6070
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1084252103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst