Provider Demographics
NPI:1417343260
Name:ASTORGA, SUNANTA ANGELA (LBA, BCBA)
Entity type:Individual
Prefix:
First Name:SUNANTA
Middle Name:ANGELA
Last Name:ASTORGA
Suffix:
Gender:F
Credentials:LBA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 33568
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92163-3568
Mailing Address - Country:US
Mailing Address - Phone:855-223-7123
Mailing Address - Fax:
Practice Address - Street 1:10015 LAKEWOOD DR SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3838
Practice Address - Country:US
Practice Address - Phone:253-358-0888
Practice Address - Fax:855-490-1545
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1-18-31324103K00000X
WABA60888474103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2108578Medicaid