Healthcare Provider Details

I. General information

NPI: 1114851433
Provider Name (Legal Business Name): ELIZANDRA ANAIE ABANDO DELGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 POWELL ST STE 900
EMERYVILLE CA
94608-1888
US

IV. Provider business mailing address

921 SAN CARLOS DR
ANTIOCH CA
94509-4741
US

V. Phone/Fax

Practice location:
  • Phone: 510-982-3773
  • Fax:
Mailing address:
  • Phone: 925-391-4431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: