Anna Virginia Dieckmeyer

Individual provider Active NPI Behavior Technician · Ladera Ranch, CA

NPI 1346844073 · NPPES record last updated Nov 23, 2020

Key facts

NPI
1346844073
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
600 Corporate Dr Ste 110
Ladera Ranch, CA 92694-2107
Phone
(949) 661-6753
NPI assigned
Nov 23, 2020
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 CA Yes

Addresses

Primary practice location

600 Corporate Dr Ste 110
Ladera Ranch, CA 92694-2107

Mailing address

600 Corporate Dr Ste 110
Ladera Ranch, CA 92694-2107
Phone (949) 661-6753

Other providers in Ladera Ranch, CA

All providers in Ladera Ranch, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.