Healthcare Provider Details

I. General information

NPI: 1174065528
Provider Name (Legal Business Name): ANA BELTRAN PANTOJA BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2016
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 W ANN RD STE 110
NORTH LAS VEGAS NV
89031-4407
US

IV. Provider business mailing address

3850 W ANN RD STE 110
NORTH LAS VEGAS NV
89031-4407
US

V. Phone/Fax

Practice location:
  • Phone: 702-323-6555
  • Fax:
Mailing address:
  • Phone: 702-323-6555
  • Fax: 818-499-0994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA1220
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: