Healthcare Provider Details

I. General information

NPI: 1710550900
Provider Name (Legal Business Name): ALYSSA BRIANNE ESPARZA BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2021
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 GLEN COVE MARINA RD E STE 102
VALLEJO CA
94591-7237
US

IV. Provider business mailing address

143 PRIMIVITO CT
VACAVILLE CA
95687-5684
US

V. Phone/Fax

Practice location:
  • Phone: 707-553-1784
  • Fax:
Mailing address:
  • Phone: 76-546-5797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-84104
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: