Provider Demographics
NPI:1518397371
Name:ANAYA, ALBERT (BCBA)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:ANAYA
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 N BROOKHURST ST STE 130
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5618
Mailing Address - Country:US
Mailing Address - Phone:714-707-7803
Mailing Address - Fax:714-984-0281
Practice Address - Street 1:421 N BROOKHURST ST STE 130
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5618
Practice Address - Country:US
Practice Address - Phone:714-707-7803
Practice Address - Fax:714-984-0281
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-13-15043103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst