Provider Demographics
NPI:1992100812
Name:PRADO ROJAS, JOSE (BCBA)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:PRADO ROJAS
Suffix:
Gender:M
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:PO BOX 25042
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-5042
Mailing Address - Country:US
Mailing Address - Phone:559-438-1245
Mailing Address - Fax:559-261-2968
Practice Address - Street 1:2316 W WHITENDALE AVE
Practice Address - Street 2:SUITE B, #4
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-6131
Practice Address - Country:US
Practice Address - Phone:559-438-1245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-13-13312103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst