Laura Michelle Anthony

Individual provider Active NPI Behavior Technician · Riverbank, CA

NPI 1487124103 · NPPES record last updated Nov 26, 2018

Key facts

NPI
1487124103
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
5501 Antique Rose Way
Riverbank, CA 95367-9505
Phone
(209) 521-4791
NPI assigned
Nov 26, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Central Valley Autism Project, Inc. Past Accepting new patients
Kadiant, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

5501 Antique Rose Way
Riverbank, CA 95367-9505

Mailing address

3425 Coffee Rd Ste C2
Modesto, CA 95355-1582

Other providers in Riverbank, CA

All providers in Riverbank, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.