Provider Demographics
NPI:1174854483
Name:ARCHIBEK, SIENNA (BCBA)
Entity Type:Individual
Prefix:
First Name:SIENNA
Middle Name:
Last Name:ARCHIBEK
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SIENNA
Other - Middle Name:MARIE
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3731 6TH AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-4383
Mailing Address - Country:US
Mailing Address - Phone:609-291-3515
Mailing Address - Fax:619-261-3529
Practice Address - Street 1:3731 6TH AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4383
Practice Address - Country:US
Practice Address - Phone:855-223-7123
Practice Address - Fax:619-374-7134
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-12-11596103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst