Provider Demographics
NPI:1356800098
Name:BANUELOS, VALERIE (MS, BCBA)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:
Last Name:BANUELOS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 VIOLETA CIR SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-2599
Mailing Address - Country:US
Mailing Address - Phone:562-395-8627
Mailing Address - Fax:
Practice Address - Street 1:6 CENTERPOINTE DR STE 700
Practice Address - Street 2:
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-2545
Practice Address - Country:US
Practice Address - Phone:714-766-2598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst