Provider Demographics
NPI:1184125429
Name:SILVEIRA BURGOS, CHELSEA ALEXANDREA (BCBA)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ALEXANDREA
Last Name:SILVEIRA BURGOS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:ALEXANDREA
Other - Last Name:SILVEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:425 BENJAMIN PLACE
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-6524
Mailing Address - Country:US
Mailing Address - Phone:209-603-2249
Mailing Address - Fax:209-670-9259
Practice Address - Street 1:425 BENJAMIN PLACE
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-6524
Practice Address - Country:US
Practice Address - Phone:209-603-2249
Practice Address - Fax:209-670-9259
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-19-40084103K00000X
NVLBA0571103K00000X
AZAZBEH-000948103K00000X
WABA61170689103K00000X
HILBABA524103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-19-40084OtherBOARD CERTIFIED BEHAVIOR ANALYST CERTIFICATE NUMBER