Individual provider Active NPI

Lizeth Mahalaleel Lopez Gastelum, LICENCIADO

  • Behavior Analyst
  • Surprise, AZ
National Provider Identifier
1659203974
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
25-439749 Issued in CA
Practice address
16485 N Stadium Way Unit 1091
Surprise, AZ 85374-4380
Phone
(510) 807-8567
NPI assigned
Jun 1, 2026
Last updated
Jun 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 25-439749 CA Primary

Addresses

Primary practice location

16485 N Stadium Way Unit 1091
Surprise, AZ 85374-4380

Mailing address

254 E 2ND St Pmb87 356
Calexico, CA 92231
Phone (510) 807-8567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25-439749CAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1780272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1659203974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 E 2ND ST PMB87 356",
            "city": "CALEXICO",
            "state": "CA",
            "postal_code": "92231",
            "telephone_number": "510-807-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16485 N STADIUM WAY UNIT 1091",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744380",
            "telephone_number": "510-807-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ GASTELUM",
        "first_name": "LIZETH",
        "middle_name": "MAHALALEEL",
        "credential": "LICENCIADO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "25-439749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.