Provider Demographics
NPI:1518474717
Name:ALATORRE, BAILEY PIETILA (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:BAILEY
Middle Name:PIETILA
Last Name:ALATORRE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MISS
Other - First Name:BAILEY
Other - Middle Name:ANNE
Other - Last Name:PIETILA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCABA
Mailing Address - Street 1:3110 CAMINO DEL RIO S STE 307
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3832
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2820 CAMINO DEL RIO S STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3822
Practice Address - Country:US
Practice Address - Phone:615-549-6608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0-19-10598103K00000X
106S00000X
CA1-24-73049103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician