Kimberly Milagros Avena

Individual provider Active NPI Behavior Technician · San Bruno, CA

NPI 1356900294 · NPPES record last updated Apr 16, 2021

Key facts

NPI
1356900294
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
901 Sneath LN Ste 105
San Bruno, CA 94066-2415
Phone
(408) 706-6855
NPI assigned
Jun 12, 2019
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

901 Sneath LN Ste 105
San Bruno, CA 94066-2415

Mailing address

16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417
Phone (619) 550-6368

Other providers in San Bruno, CA

All providers in San Bruno, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.