Provider Demographics
NPI:1891360939
Name:VASQUEZ, BRIANNA EDITH (BCBA)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:EDITH
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 HOLLIPAT CENTER DR APT 3
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2456
Mailing Address - Country:US
Mailing Address - Phone:760-518-9744
Mailing Address - Fax:
Practice Address - Street 1:4141 STATE ST STE E-1213
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1814
Practice Address - Country:US
Practice Address - Phone:805-603-4968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst