Provider Demographics
NPI:1407258254
Name:AVALOS, CINDY G (MA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:G
Last Name:AVALOS
Suffix:
Gender:F
Credentials:MA, 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 10054
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92838-6054
Mailing Address - Country:US
Mailing Address - Phone:714-882-1409
Mailing Address - Fax:714-844-9036
Practice Address - Street 1:1820 N SUNNYCREST DR
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92838-6900
Practice Address - Country:US
Practice Address - Phone:714-882-1409
Practice Address - Fax:714-844-9036
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABCBA 1-13-13919103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABCBA 1-13-13919OtherBEHAVIOR ANALYST CERTIFICATION BOARD