MEDICARE: PABLO ESTEBAN ORTEGA CASILLAS 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
1	103K00000X	Behavior Analyst	1-22-62435	CA

General Provider Information

NPI Number	:	1598221558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PABLO ESTEBAN ORTEGA CASILLAS BCBA

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:	772-675-9100

Provider Business Practice Location Address
First Line	:	702 MANGROVE AVE
Second Line	:	SUITE 168
City	:	CHICO
State	:	CA
Zip	:	95926-3948
Country	:	US
Telephone Number	:	800-538-8365
Fax Number	:	772-675-9100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2019
Last Update Date	:	02/10/2026

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