Healthcare Provider Details

I. General information

NPI: 1750974234
Provider Name (Legal Business Name): IRA GABRIELA PASCUAL CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2021
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5870 EL CAMINO REAL STE 101
CARLSBAD CA
92008-8816
US

IV. Provider business mailing address

5870 EL CAMINO REAL STE 101
CARLSBAD CA
92008-8816
US

V. Phone/Fax

Practice location:
  • Phone: 760-539-5818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-126309
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-82556
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: