Marcus Broussard
Individual provider Active NPI Behavior Technician · Rowland Heights, CA
NPI 1124771027 · NPPES record last updated Jan 31, 2022
Key facts
- NPI
- 1124771027
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 17462 Colima Rd
Rowland Heights, CA 91748-1633 - Phone
- (855) 223-7123
- Fax
- (619) 550-6368
- NPI assigned
- Jan 31, 2022
- Sex
- Male
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
17462 Colima Rd
Rowland Heights, CA 91748-1633
Mailing address
16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417
Phone (855) 223-7123
Other providers in Rowland Heights, CA
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- Anallely Botello Molina
- Adam Bou Hamdan
- Elizabeth Stephanie Brammer
- Shannen Briones Margarito
- Guadalupe Buelna
- Anthony Bull
- Burn Park M D Inc
- Sangjun Byeon
- Amanda Vanessa Cabrera
All providers in Rowland Heights, CA · Behavior Technician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2022. 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.