Provider Demographics
NPI:1538683842
Name:BARTUS, ANA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:BARTUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1366 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-3210
Mailing Address - Country:US
Mailing Address - Phone:323-640-2939
Mailing Address - Fax:
Practice Address - Street 1:1366 W 2ND ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-3210
Practice Address - Country:US
Practice Address - Phone:323-640-2939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-18-32441103K00000X
CARBT-15-08049103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst