Marco Quezada
Individual provider Active NPI Behavior Analyst · Agoura, CA
NPI 1033775325 · NPPES record last updated May 13, 2019
Key facts
- NPI
- 1033775325
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 30343 Canwood St Ste 100
Agoura, CA 91301-4328 - Phone
- (805) 230-3701
- NPI assigned
- May 13, 2019
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
30343 Canwood St Ste 100
Agoura, CA 91301-4328
Mailing address
30343 Canwood St Ste 100
Agoura, CA 91301-4328
Phone (805) 230-3701
Other providers in Agoura, CA
- Denise C Kraus
- Stacey Lux
- Madison Marer
- Mikaela Martinez
- Brandon Moritz
- Kathryn Redd
- Allison Sangiacomo
- Leslie Spero
- Sanjay Udani
- Martha Snyder Vaughan
All providers in Agoura, CA · Behavior Analyst in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.