Provider Demographics
NPI:1841605292
Name:CHANG & ASSOCIATES BEHAVIOR CONSULTING, LLC
Entity type:Organization
Organization Name:CHANG & ASSOCIATES BEHAVIOR CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-698-2896
Mailing Address - Street 1:39420 LIBERTY ST
Mailing Address - Street 2:252A
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2200
Mailing Address - Country:US
Mailing Address - Phone:510-698-2896
Mailing Address - Fax:
Practice Address - Street 1:39420 LIBERTY ST
Practice Address - Street 2:252A
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2200
Practice Address - Country:US
Practice Address - Phone:510-698-2896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-24
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1095185103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty