Provider Demographics
NPI:1730574955
Name:GARZA, RYANNE AURELEE TRIAS (BCBA)
Entity type:Individual
Prefix:MISS
First Name:RYANNE AURELEE
Middle Name:TRIAS
Last Name:GARZA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MISS
Other - First Name:RYANNE
Other - Middle Name:TRIAS
Other - Last Name:AMOMONPON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA
Mailing Address - Street 1:5432 W ATHENS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-2700
Mailing Address - Country:US
Mailing Address - Phone:559-907-6126
Mailing Address - Fax:
Practice Address - Street 1:7413 N CEDAR AVE STE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3833
Practice Address - Country:US
Practice Address - Phone:559-930-2720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-03
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-17956103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst