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)CodeLicenseStatePrimary
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

Other providers in Lafayette, CA

All providers in Lafayette, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.