Provider Demographics
NPI:1003478454
Name:SUAREZ, DANIELA (BCBA)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:SUAREZ
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 1:4701 W LINDA VISTA BLVD APT 17102
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-5440
Mailing Address - Country:US
Mailing Address - Phone:415-840-6890
Mailing Address - Fax:
Practice Address - Street 1:4701 W LINDA VISTA BLVD APT 17102
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-5440
Practice Address - Country:US
Practice Address - Phone:415-840-6890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-06
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-22-62007103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA14826048OtherKAISER