Individual provider Active NPI

Ariana Guadalupe Elizalde

  • Behavior Analyst
  • Fresno, CA
National Provider Identifier
1902565476
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
103K00000X Issued in CA
Practice address
1752 E Bullard Ave Ste 101
Fresno, CA 93710-5864
Phone
(559) 330-1157
NPI assigned
Dec 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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 103K00000X CA Primary

Addresses

Primary practice location

1752 E Bullard Ave Ste 101
Fresno, CA 93710-5864

Mailing address

1752 E Bullard Ave Ste 101
Fresno, CA 93710-5864
Phone (559) 330-1157

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
103K00000XCAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1902565476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1752 E BULLARD AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105864",
            "telephone_number": "559-330-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 E BULLARD AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105864",
            "telephone_number": "559-330-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZALDE",
        "first_name": "ARIANA",
        "middle_name": "GUADALUPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "103K00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.