Laura Jean Buckwalter

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

25-403034 Issued in CA

Practice address

2755 55TH St
San Diego, CA 92105-5043

Phone

(619) 493-0077

NPI assigned

Jan 21, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1467264135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4687 KANSAS ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921163209",
            "telephone_number": "717-380-1487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 55TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921055043",
            "telephone_number": "619-493-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKWALTER",
        "first_name": "LAURA",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "25-403034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Buckner, PT, DPT
• Joseph Anthony Buckner, PA-C
• Rebecca Buckner
• Scott Buckner, LVN
• Tina Louise Buckner, PSY.D.
• Naomi R. Buckwalter, MD
• Ashley Buckwold, PMHNP-BC
• Steven F Bucky, PH.D.
• Cristina Gonzalez Buclatin, PT, DPT
• Lynn Anne Buczek, L.AC.

• Behavior Technician in San Diego, CA
• Providers in San Diego, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.