Provider Demographics
NPI:1770941387
Name:TALAMANTES, BRIANNA NICOLE (MS, CCC-SLP, BCBA)
Entity type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:NICOLE
Last Name:TALAMANTES
Suffix:
Gender:F
Credentials:MS, CCC-SLP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 W DUARTE RD
Mailing Address - Street 2:UNIT G #818
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007
Mailing Address - Country:US
Mailing Address - Phone:209-487-2614
Mailing Address - Fax:
Practice Address - Street 1:713 W DUARTE RD
Practice Address - Street 2:UNIT G #818
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007
Practice Address - Country:US
Practice Address - Phone:209-487-2614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
CA24996235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst