Provider Demographics
NPI:1609199512
Name:BEHAVIORAL INTERVENTION ASSOCIATION
Entity type:Organization
Organization Name:BEHAVIORAL INTERVENTION ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DETMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-652-7445
Mailing Address - Street 1:6333 TELEGRAPH AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1359
Mailing Address - Country:US
Mailing Address - Phone:877-242-2884
Mailing Address - Fax:510-652-9288
Practice Address - Street 1:6333 TELEGRAPH AVE STE 102
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1359
Practice Address - Country:US
Practice Address - Phone:877-242-2884
Practice Address - Fax:510-652-9288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency