MEDICARE: ALIA MINOLETTI

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1619821071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALIA MINOLETTI

Provider Business Mailing Address
First Line	:	3604 OCEAN RANCH BLVD
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-2669
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9632 W EMERALD ST STE E
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83704-9762
Country	:	US
Telephone Number	:	619-356-0358
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2026
Last Update Date	:	02/23/2026

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Directions to “ ALIA MINOLETTI ” Practice Location

Language	Start Address	Practice Location

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