Provider Demographics
NPI:1841517703
Name:BURKHOLDER, ERIC ODEN (PHD, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ODEN
Last Name:BURKHOLDER
Suffix:
Gender:M
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 FOOTHILL DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5630
Mailing Address - Country:US
Mailing Address - Phone:510-331-1354
Mailing Address - Fax:
Practice Address - Street 1:342 FOOTHILL DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-5630
Practice Address - Country:US
Practice Address - Phone:510-331-1354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst