Josephine J Irvin

Individual provider Active NPI Behavior Technician · American Canyon, CA

NPI 1255835948 · NPPES record last updated Mar 19, 2018

Key facts

NPI
1255835948
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-17-46152 (CA)
Practice address
120 Theresa Ave
American Canyon, CA 94503-9654
Phone
(707) 561-0134
NPI assigned
Mar 19, 2018
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-17-46152CAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
McGrew Behavioral Health Services, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-17-46152 CA Yes

Addresses

Primary practice location

120 Theresa Ave
American Canyon, CA 94503-9654

Mailing address

120 Theresa Ave
American Canyon, CA 94503-9654

Other providers in American Canyon, CA

All providers in American Canyon, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.