Provider Demographics
NPI:1710373949
Name:BASE, ANA C (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:C
Last Name:BASE
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:MS
Other - First Name:ANA
Other - Middle Name:C
Other - Last Name:FRANCISCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:3375 MESA RIDGE RD APT 107
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-6730
Mailing Address - Country:US
Mailing Address - Phone:760-916-5910
Mailing Address - Fax:760-683-6778
Practice Address - Street 1:3375 MESA RIDGE RD APT 107
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-6730
Practice Address - Country:US
Practice Address - Phone:760-916-5910
Practice Address - Fax:760-683-6778
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11518111103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst