Provider Demographics
NPI:1154707768
Name:CADIZ, VANESSA (BCBA)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:CADIZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 INLAND EMPIRE BLVD
Mailing Address - Street 2:STE. 101
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-4802
Mailing Address - Country:US
Mailing Address - Phone:909-483-5000
Mailing Address - Fax:909-483-5044
Practice Address - Street 1:2930 INLAND EMPIRE BLVD
Practice Address - Street 2:STE. 101
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-4802
Practice Address - Country:US
Practice Address - Phone:909-483-5000
Practice Address - Fax:909-483-5044
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11518734103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst