Provider Demographics
NPI:1013346808
Name:BERTOLOTTI, CYNTHIA (BCBA)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:BERTOLOTTI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:YOTSUYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6601 OWENS DR STE 270
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3364
Mailing Address - Country:US
Mailing Address - Phone:866-278-1520
Mailing Address - Fax:
Practice Address - Street 1:6601 OWENS DR STE 270
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588
Practice Address - Country:US
Practice Address - Phone:866-278-1520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-13-14412103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst