Provider Demographics
NPI:1538550561
Name:EDUCATIONAL & THERAPEUTIC SERVICES, INC.
Entity type:Organization
Organization Name:EDUCATIONAL & THERAPEUTIC SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:DIOGO
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:510-688-8166
Mailing Address - Street 1:27126 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94542-2324
Mailing Address - Country:US
Mailing Address - Phone:510-688-8166
Mailing Address - Fax:
Practice Address - Street 1:27126 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94542-2324
Practice Address - Country:US
Practice Address - Phone:510-688-8166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-21--12171252Y00000X
CA1-12-12171251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency