Keanu Abassi

Individual provider Active NPI Behavior Technician · Orange, CA

NPI 1124861158 · NPPES record last updated Jun 17, 2024

Key facts

NPI
1124861158
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1100 W Town and Country Rd Ste 1250
Orange, CA 92868-4633
Phone
(949) 357-2556
Fax
(855) 568-2494
NPI assigned
Jun 17, 2024
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)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

1100 W Town and Country Rd Ste 1250
Orange, CA 92868-4633

Mailing address

100 N Pacific Coast Hwy Ste 1400
El Segundo, CA 90245-5602
Phone (310) 856-0800

Other providers in Orange, CA

All providers in Orange, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.