Healthcare Provider Details

I. General information

NPI: 1497261903
Provider Name (Legal Business Name): NATHAN ALEX ZANZE BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2017
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 W ORANGEWOOD AVE STE 110
ORANGE CA
92868-5056
US

IV. Provider business mailing address

1319 CALLE AVANZADO
SAN CLEMENTE CA
92673-6351
US

V. Phone/Fax

Practice location:
  • Phone: 714-696-2862
  • Fax: 714-242-9308
Mailing address:
  • Phone: 949-272-6146
  • Fax: 888-847-8864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-16-18490
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-65407
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number11341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: