Provider Demographics
NPI:1376924985
Name:ACEVES SANCHEZ, MONTSERRAT (BCBA)
Entity Type:Individual
Prefix:
First Name:MONTSERRAT
Middle Name:
Last Name:ACEVES SANCHEZ
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:PO BOX 33568
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92163-3568
Mailing Address - Country:US
Mailing Address - Phone:855-223-7123
Mailing Address - Fax:619-374-7134
Practice Address - Street 1:3760 S MASON RD STE 10
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-7729
Practice Address - Country:US
Practice Address - Phone:855-223-7123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2024-01-08
Deactivation Date:2018-01-04
Deactivation Code:
Reactivation Date:2018-07-19
Provider Licenses
StateLicense IDTaxonomies
TX1980103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1980OtherTEXAS DEPARTMENT OF LICENSING AND REGULATION
1-17-28910OtherBACB