Provider Demographics
NPI:1770120206
Name:LEUTA, PARADISE (BCBA)
Entity type:Individual
Prefix:
First Name:PARADISE
Middle Name:
Last Name:LEUTA
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 1:2080 N TUSTIN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-7875
Mailing Address - Country:US
Mailing Address - Phone:855-581-0100
Mailing Address - Fax:949-709-0311
Practice Address - Street 1:1717 E CARY ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-7024
Practice Address - Country:US
Practice Address - Phone:804-215-5600
Practice Address - Fax:804-800-9329
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-03
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician