Healthcare Provider Details

I. General information

NPI: 1801502216
Provider Name (Legal Business Name): ABA STARS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 01/30/2023
Certification Date: 01/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530B HARKLE RD STE 100
SANTA FE NM
87505-4739
US

IV. Provider business mailing address

530B HARKLE RD STE 100
SANTA FE NM
87505-4739
US

V. Phone/Fax

Practice location:
  • Phone: 310-870-3640
  • Fax:
Mailing address:
  • Phone: 310-870-3640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NATALIA ALVAREZ
Title or Position: BCBA AND FOUNDER
Credential: BCBA
Phone: 310-870-3640