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General NPI Number Information
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NPI Number | 1770904088
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Entity Type | Individual
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Provider Name | KEITH ERIC BELTON BCBA-D, LEP
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Gender | Male
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Dates
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Enumeration Date | 01/05/2014
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 3045 S ARCHIBALD AVE STE H-1043
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City | ONTARIO
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State | CA
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Zip | 91761-9001
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Country | US
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Telephone | 855-832-6727
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Fax | 772-675-9100
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Provider Business Mailing Address
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Address Line | 7108 SOUTH KANNER KWY.
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City | STUART
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State | FL
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Zip | 34997-7462
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Country | US
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Telephone | 855-832-6727
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Fax | 772-675-9100
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number | 2967
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 2967
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-13-13521
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License Number State | CA
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