Provider Demographics
NPI:1295237147
Name:CASTRO ALEJANDRE, JUAN MANUEL (BCBA)
Entity type:Individual
Prefix:MR
First Name:JUAN
Middle Name:MANUEL
Last Name:CASTRO ALEJANDRE
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16946 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3613
Mailing Address - Country:US
Mailing Address - Phone:888-320-1272
Mailing Address - Fax:855-978-6050
Practice Address - Street 1:2601 SKYWAY DR STE A1
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1419
Practice Address - Country:US
Practice Address - Phone:805-456-2380
Practice Address - Fax:855-978-6050
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABCAT00002520106S00000X
CA1-21-55596103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician