Susana Avalos

Individual provider Active NPI Behavior Technician · Wildomar, CA

NPI 1295486140 · NPPES record last updated Jan 12, 2022

Key facts

NPI
1295486140
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
32395 Clinton Keith Rd Ste B12
Wildomar, CA 92595-7568
Phone
(951) 200-5532
NPI assigned
Jan 12, 2022
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

32395 Clinton Keith Rd Ste B12
Wildomar, CA 92595-7568

Mailing address

32395 Clinton Keith Rd Ste B12
Wildomar, CA 92595-7568
Phone (951) 200-5532

Other providers in Wildomar, CA

All providers in Wildomar, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.