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NPI Code Detail

MEDICARE: ELIANA KAYLEEN BALDOVINOS BCBA

MEDICARE: ELIANA KAYLEEN BALDOVINOS BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1518512474
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIANA KAYLEEN BALDOVINOS BCBA
Provider Business Mailing Address
First Line : 3210 W BURBANK BLVD STE B
Second Line :
City : BURBANK
State : CA
Zip : 91505-2200
Country : US
Telephone Number : 818-356-1401
Fax Number :
Provider Business Practice Location Address
First Line : 3210 W BURBANK BLVD STE B
Second Line :
City : BURBANK
State : CA
Zip : 91505-2200
Country : US
Telephone Number : 818-356-1401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2019
Last Update Date : 06/13/2024

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