Provider Demographics
NPI:1962075556
Name:BARTEL, ABIGAIL (MS, BCBA)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:BARTEL
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 BRIAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-2668
Mailing Address - Country:US
Mailing Address - Phone:408-540-8266
Mailing Address - Fax:
Practice Address - Street 1:600 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-5821
Practice Address - Country:US
Practice Address - Phone:734-940-8649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-21-51327103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst