Leanne Agbulos

Individual provider Active NPI Behavior Technician · San Bruno, CA

NPI 1194383679 · NPPES record last updated May 30, 2019

Key facts

NPI
1194383679
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1001 Sneath LN Ste 200
San Bruno, CA 94066-2349
Phone
(510) 268-8120
NPI assigned
May 30, 2019
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

1001 Sneath LN Ste 200
San Bruno, CA 94066-2349

Mailing address

1001 Sneath LN Ste 200
San Bruno, CA 94066-2349
Phone (510) 268-8120

Other providers in San Bruno, CA

All providers in San Bruno, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.