Healthcare Provider Details

I. General information

NPI: 1285379149
Provider Name (Legal Business Name): CIERRA MARIE MARIANO MA, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 STARR AVE
VALLEJO CA
94590-7154
US

IV. Provider business mailing address

13021 N CESAR CHAVEZ DR
EL MIRAGE AZ
85335-3392
US

V. Phone/Fax

Practice location:
  • Phone: 510-270-0211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: