Samantha Avila
Individual provider Active NPI Behavior Technician · El Dorado Hills, CA
NPI 1497515670 · NPPES record last updated Mar 22, 2024
Key facts
- NPI
- 1497515670
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 5170 Golden Foothill Pkwy # 143
El Dorado Hills, CA 95762-9608 - Phone
- (916) 280-1351
- NPI assigned
- Mar 22, 2024
- Sex
- Female
- 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
5170 Golden Foothill Pkwy # 143
El Dorado Hills, CA 95762-9608
Mailing address
5170 Golden Foothill Pkwy # 143
El Dorado Hills, CA 95762-9608
Phone (916) 280-1351
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2024. 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.