Provider Demographics
NPI:1356034664
Name:BUENO, SERGIO (BCBA)
Entity type:Individual
Prefix:
First Name:SERGIO
Middle Name:
Last Name:BUENO
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9201 OAKDALE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-6546
Mailing Address - Country:US
Mailing Address - Phone:833-227-3454
Mailing Address - Fax:833-446-0086
Practice Address - Street 1:2601 SKYWAY DR STE A1-9
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1416
Practice Address - Country:US
Practice Address - Phone:833-227-3454
Practice Address - Fax:833-446-0086
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst