Provider Demographics
NPI:1326505215
Name:ESQUIVEL RADZIENDA, DEYSSY (BCBA)
Entity type:Individual
Prefix:
First Name:DEYSSY
Middle Name:
Last Name:ESQUIVEL RADZIENDA
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 1:299 W HILLCREST DR STE 110
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-7824
Mailing Address - Country:US
Mailing Address - Phone:805-379-1401
Mailing Address - Fax:805-379-1491
Practice Address - Street 1:8025 N POINT BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3291
Practice Address - Country:US
Practice Address - Phone:704-780-4271
Practice Address - Fax:805-379-1491
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst