Provider Demographics
NPI:1992161905
Name:ARAGA, EDWARD ALLEN (BA)
Entity type:Individual
Prefix:
First Name:EDWARD ALLEN
Middle Name:
Last Name:ARAGA
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 BUTTERCUP CIR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-7320
Mailing Address - Country:US
Mailing Address - Phone:707-673-7241
Mailing Address - Fax:
Practice Address - Street 1:149 BUTTERCUP CIR
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-7320
Practice Address - Country:US
Practice Address - Phone:707-673-7241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst