Alyssia Ramona Baca, AA

Individual provider Active NPI Behavior Technician · Chimayo, NM

NPI 1659926764 · NPPES record last updated Aug 6, 2019

Key facts

NPI
1659926764
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
324 Juan Medina Road
Chimayo, NM 87522
Phone
(505) 927-1303
NPI assigned
Aug 6, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Associate of Arts

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

324 Juan Medina Road
Chimayo, NM 87522

Mailing address

324 Juan Medina Road
Chimayo, NM 87522
Phone (505) 927-1303

Other providers in Chimayo, NM

All providers in Chimayo, NM · Behavior Technician in New Mexico

Sources for this page

Verify at the official NPI Registry.