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NPI Code Detail

MEDICARE: ELYSE ALTALINDA CARLOS LBA/BCBA

MEDICARE: ELYSE ALTALINDA CARLOS LBA/BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-24-71811

General Provider Information

NPI Number : 1528546835
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELYSE ALTALINDA CARLOS LBA/BCBA
Provider Business Mailing Address
First Line : 3100 OAK RD STE 100
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94597-2078
Country : US
Telephone Number : 510-422-3959
Fax Number :
Provider Business Practice Location Address
First Line : 3100 OAK RD STE 100
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94597-2078
Country : US
Telephone Number : 510-422-3959
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2018
Last Update Date : 04/06/2026

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