Provider Demographics
NPI:1619476173
Name:MIRANDA LOYOLA, PATRICIA (MED, BCBA)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:MIRANDA LOYOLA
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:MIRANDA LOYOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:38397 HONEYSUCKLE DR
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33525-8701
Mailing Address - Country:US
Mailing Address - Phone:562-810-0402
Mailing Address - Fax:
Practice Address - Street 1:10080 ROSECANS AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706
Practice Address - Country:US
Practice Address - Phone:833-227-3454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-09
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-23-67412103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst