Provider Demographics
NPI:1154718336
Name:ACEVES, MARICELA
Entity type:Individual
Prefix:
First Name:MARICELA
Middle Name:
Last Name:ACEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARICELA
Other - Middle Name:BANGLADESH
Other - Last Name:ACEVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:12443 LEWIS ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-4650
Mailing Address - Country:US
Mailing Address - Phone:714-748-4440
Mailing Address - Fax:714-748-4445
Practice Address - Street 1:12443 LEWIS ST
Practice Address - Street 2:SUITE 201
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4650
Practice Address - Country:US
Practice Address - Phone:714-748-4440
Practice Address - Fax:714-748-4445
Is Sole Proprietor?:No
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-18211103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst