Provider Demographics
NPI:1871915678
Name:CALIFORNIA AUTISM CENTER, INC.
Entity type:Organization
Organization Name:CALIFORNIA AUTISM CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICE
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FORATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-492-7900
Mailing Address - Street 1:5132 N PALM AVE
Mailing Address - Street 2:BOX #303
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2236
Mailing Address - Country:US
Mailing Address - Phone:559-385-5858
Mailing Address - Fax:
Practice Address - Street 1:1630 W. SHAW AVE
Practice Address - Street 2:SUITE 190
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8114
Practice Address - Country:US
Practice Address - Phone:559-492-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty