Provider Demographics
NPI:1548533177
Name:BASS, SARAH LYNN (BCBA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:BASS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LYNN
Other - Last Name:HUXSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 W TOWN AND COUNTRY RD
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4600
Mailing Address - Country:US
Mailing Address - Phone:844-669-7827
Mailing Address - Fax:877-644-7545
Practice Address - Street 1:1100 W TOWN AND COUNTRY RD
Practice Address - Street 2:SUITE 1250
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4600
Practice Address - Country:US
Practice Address - Phone:844-669-7827
Practice Address - Fax:877-644-7545
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-20880103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst