Provider Demographics
NPI:1245778885
Name:BEAL, DANYELLE SHARELLE GOITIA (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:DANYELLE
Middle Name:SHARELLE GOITIA
Last Name:BEAL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6428 PACIFIC BLVD
Mailing Address - Street 2:306
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-4104
Mailing Address - Country:US
Mailing Address - Phone:562-715-4093
Mailing Address - Fax:
Practice Address - Street 1:6428 PACIFIC BLVD
Practice Address - Street 2:306
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4104
Practice Address - Country:US
Practice Address - Phone:562-715-4093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-10166103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst