Loni Adesanmi

Individual provider Active NPI Behavior Technician · Costa Mesa, CA

NPI 1154890499 · NPPES record last updated Nov 15, 2018

Key facts

NPI
1154890499
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1111 Baker St
Costa Mesa, CA 92626-4138
Phone
(818) 241-6780
Fax
(818) 241-6853
NPI assigned
Nov 15, 2018
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 Yes

Addresses

Primary practice location

1111 Baker St
Costa Mesa, CA 92626-4138

Mailing address

206 N Jackson St
Glendale, CA 91206-4330
Phone (818) 241-6780

Other providers in Costa Mesa, CA

All providers in Costa Mesa, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.