Provider Demographics
NPI:1255712485
Name:SOTOMAYOR-GALINDO, JAVIER (BCBA)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:SOTOMAYOR-GALINDO
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:JAVIER
Other - Middle Name:
Other - Last Name:SOTOMAYOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA
Mailing Address - Street 1:3636 CAMINO DEL RIO N
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1703
Mailing Address - Country:US
Mailing Address - Phone:619-603-1410
Mailing Address - Fax:
Practice Address - Street 1:3636 CAMINO DEL RIO N
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1703
Practice Address - Country:US
Practice Address - Phone:619-603-1410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-17793103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst