Healthcare Provider Details

I. General information

NPI: 1558769299
Provider Name (Legal Business Name): MARITZA PARDO MA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2014
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1063 MCGAW AVE
IRVINE CA
92614-5505
US

IV. Provider business mailing address

8423 LULLABY LN
PANORAMA CITY CA
91402-3712
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-1111
  • Fax:
Mailing address:
  • Phone: 818-281-3648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-15761
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: