Enibey Acosta

Individual provider Active NPI Behavior Technician · Ontario, CA

NPI 1497366108 · NPPES record last updated Aug 19, 2020

Key facts

NPI
1497366108
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
4688 Ontario Mills Pkwy
Ontario, CA 91764-5104
Phone
(714) 867-4657
NPI assigned
Aug 14, 2020
Sex
Female
Sole proprietor
Yes

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)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

4688 Ontario Mills Pkwy
Ontario, CA 91764-5104

Mailing address

4688 Ontario Mills Pkwy
Ontario, CA 91764-5104

Other providers in Ontario, CA

All providers in Ontario, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.