Nicholas Wayne Consolo

Individual provider Active NPI Behavior Technician · La Crescenta, CA

NPI 1508614736 · NPPES record last updated May 13, 2024

Key facts

NPI
1508614736
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
3123 1/2 Foothill Blvd Apt 16
La Crescenta, CA 91214-2637
Phone
(818) 919-4988
NPI assigned
May 13, 2024
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

3123 1/2 Foothill Blvd Apt 16
La Crescenta, CA 91214-2637

Mailing address

3123 1/2 Foothill Blvd Apt 16
La Crescenta, CA 91214-2637
Phone (818) 919-4988

Other providers in La Crescenta, CA

All providers in La Crescenta, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.