Jordan Broxton
Individual provider Active NPI Behavior Technician · Arcata, CA
NPI 1417736729 · NPPES record last updated Sep 26, 2023
Key facts
- NPI
- 1417736729
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 901 O St
Suite C
Arcata, CA 95521-5789 - Phone
- (303) 989-8169
- NPI assigned
- Sep 26, 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
901 O St
Suite C
Arcata, CA 95521-5789
Mailing address
901 O St
Suite C
Arcata, CA 95521-5789
Other providers in Arcata, CA
- Adam Brown
- Bridget Brown
- Chad Brown
- Jennifer Valerie Brown
- Travis Brown
- Erin Buchan
- Sandra B Buchheister
- Tess Bunting
- Brighid Burkhalter
- Judy Ann Burns
All providers in Arcata, 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 Sep 26, 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.