Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Behavioranalystsupervisor

Organization Behavior Analyst · NPI 1790157154

Behavioranalystsupervisor is a Behavior Analyst in Mount Shasta, California. Licensed in California. Registered with an NPI since 2015.

Licensed in
CA
In the registry since
2015
Specialties on file
2

Practice location Address checks out

809 McCloud Ave
Mount Shasta, CA 96067-9603
Phone: (530) 227-2883
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X · Licence 1-13-12972 (CA)
School Psychologist Taxonomy 103TS0200X · Licence LEP3635 (CA)

Record details

NPI number1790157154
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Van Laeken — Owner/Operator · (530) 227-2883
NPI enumeratedOctober 26, 2015
Last updated in NPPESOctober 26, 2015
Mailing address809 McCloud Ave, Mount Shasta, CA 96067-9603

Other providers in Mount Shasta