Provider Demographics
NPI:1619589488
Name:SALTZ, NATASHA (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:SALTZ
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 1:2217 BRINDISI
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3253
Mailing Address - Country:US
Mailing Address - Phone:949-374-9505
Mailing Address - Fax:
Practice Address - Street 1:2217 BRINDISI
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-3253
Practice Address - Country:US
Practice Address - Phone:949-374-9505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-20-43951103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty