Michael Erwin Perena Abad
Individual provider Active NPI Behavior Technician · Manhattan Beach, CA
NPI 1376225201 · NPPES record last updated Aug 1, 2023
Key facts
- NPI
- 1376225201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 711 11TH St
Manhattan Beach, CA 90266-4823 - Phone
- (562) 371-5677
- NPI assigned
- Aug 1, 2023
- Sex
- Male
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
711 11TH St
Manhattan Beach, CA 90266-4823
Mailing address
711 11TH St
Manhattan Beach, CA 90266-4823
Phone (562) 371-5677
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All providers in Manhattan Beach, 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 1, 2023. 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.