Aketzali Balderrama, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BEH-000664 Issued in AZ

Practice address

10150 W Desert River Blvd Ste 160
Glendale, AZ 85307-3010

Phone

(623) 693-2954

NPI assigned

Jul 26, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Adventure ABA, LLC

  • Behavior Analyst
  • Glendale, AZ
  • NPI 1588178149
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1356828909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6232 N 7TH ST STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850141850",
            "telephone_number": "623-693-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 W DESERT RIVER BLVD STE 160",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853073010",
            "telephone_number": "623-693-2954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6232 N 7th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850141850",
            "country_code": "US",
            "telephone_number": "623-693-2954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALDERRAMA",
        "first_name": "AKETZALI",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AZ",
            "license": "RBT-18-60729",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BEH-000664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley Jean Baker, RBT
• Radhakrishnan Balakrishnan, M.D.
• Priya Sabumon Balan, RN
• Balanced Mind Psychiatry, LLC
• Andrei Balandin
• Cody Melissa Baldree
• Courtney Baldwin, M.S., CCC-SLP
• Baljeet Singh MD LLC
• Sharleen Villasol Ballance, NP
• Matthew Ballard

• Behavior Analyst in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.