Healthcare Provider Details
I. General information
NPI: 1801406293
Provider Name (Legal Business Name): EDUARDO SALINAS ORDAZ M.S., BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/31/2020
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4150 LATHAM ST STE A
RIVERSIDE CA
92501-1735
US
IV. Provider business mailing address
1151 DOVE ST
NEWPORT BEACH CA
92660-2840
US
V. Phone/Fax
- Phone: 951-363-0200
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-23-70385 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: