Andre J Allen

Individual provider Active NPI Behavior Technician · Vallejo, CA

NPI 1013595982 · NPPES record last updated Mar 31, 2021

Key facts

NPI
1013595982
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
150 Glen Cove Marina Rd E Ste 102
Vallejo, CA 94591-7237
Phone
(916) 539-8445
NPI assigned
Mar 31, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

150 Glen Cove Marina Rd E Ste 102
Vallejo, CA 94591-7237

Mailing address

1955 Lernhart St
Napa, CA 94559-4443
Phone (415) 738-9102

Other providers in Vallejo, CA

All providers in Vallejo, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.