Rhonda Lea Hallock

Individual provider Active NPI Behavior Technician · Bayside, CA

NPI 1164032108 · NPPES record last updated Aug 4, 2020

Key facts

NPI
1164032108
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-17-36212 (CA)
Practice address
2670 Jacoby Creek Rd
Bayside, CA 95524-9379
Phone
(707) 672-4885
NPI assigned
Aug 4, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-17-36212CAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Lauren Cook Bcba LLC Past
since Aug 9, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-17-36212 CA Yes

Addresses

Primary practice location

2670 Jacoby Creek Rd
Bayside, CA 95524-9379

Mailing address

3081 Pomona LN
Arcata, CA 95521-5199
Phone (707) 599-3941

Other providers in Bayside, CA

All providers in Bayside, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.