Edzle C Agabao
Individual provider Active NPI Behavior Technician · Santa Clara, CA
NPI 1477051019 · NPPES record last updated Jan 29, 2018
Key facts
- NPI
- 1477051019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-17-3027-77297 (CA)
- Practice address
- 3170 De la Cruz Blvd Ste 105
Santa Clara, CA 95054-2411 - Phone
- (408) 423-8076
- NPI assigned
- Jan 29, 2018
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-17-3027-77297 | CA | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-17-3027-77297 | CA | Yes |
Addresses
Primary practice location
3170 De la Cruz Blvd Ste 105
Santa Clara, CA 95054-2411
Mailing address
21600 Oxnard St Ste 1800
Woodland Hills, CA 91367-7807
Phone (818) 345-2345
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- Anahita Aghaei Lasboo
- Jennier Aguayo Ruiz
- Adrienne Aguiar
- Scarleth Sugey Aguilar Funes
All providers in Santa Clara, 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 Jan 29, 2018. 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.