Ellie Grubb

Individual provider Active NPI Behavior Technician · Pacifica, CA

NPI 1093666752 · NPPES record last updated Feb 6, 2026

Key facts

NPI
1093666752
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
853 Reina del Mar Ave
Pacifica, CA 94044-3157
Phone
(650) 484-6848
NPI assigned
Feb 6, 2026
Sex
Female
Sole proprietor
No

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 CA Yes

Addresses

Primary practice location

853 Reina del Mar Ave
Pacifica, CA 94044-3157

Mailing address

853 Reina del Mar Ave
Pacifica, CA 94044-3157
Phone (650) 484-6848

Other providers in Pacifica, CA

All providers in Pacifica, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.