Samantha Rose Bauer
Individual provider Active NPI Behavior Technician · Lafayette, CA
NPI 1336815893 · NPPES record last updated Aug 17, 2021
Key facts
- NPI
- 1336815893
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 3650 Mt Diablo Blvd Ste 107
Lafayette, CA 94549-3768 - Phone
- (866) 523-4268
- NPI assigned
- Aug 17, 2021
- Sex
- Female
- Sole proprietor
- Yes
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
3650 Mt Diablo Blvd Ste 107
Lafayette, CA 94549-3768
Mailing address
PO Box 399318
San Francisco, CA 94139-9318
Phone (866) 523-4268
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- Dan B Barrett
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All providers in Lafayette, CA · Behavior Technician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.