Healthcare Provider Details

I. General information

NPI: 1215307228
Provider Name (Legal Business Name): ANDREA MARIANA SANTOSLOPEZ MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA MARIANA SANTOS

II. Dates (important events)

Enumeration Date: 10/02/2015
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 E WALKER ST
ORLAND CA
95963-2203
US

IV. Provider business mailing address

390 RIO LINDO AVE APT 46
CHICO CA
95926-1939
US

V. Phone/Fax

Practice location:
  • Phone: 530-884-4878
  • Fax:
Mailing address:
  • Phone: 530-961-2818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-82106
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: