Jennifer Cuellar

Individual provider Active NPI Behavior Technician · Hercules, CA

NPI 1508627993 · NPPES record last updated Jan 22, 2024

Key facts

NPI
1508627993
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
500 Alfred Nobel Dr
Hercules, CA 94547-1838
Phone
(510) 863-2507
NPI assigned
Jan 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)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

500 Alfred Nobel Dr
Hercules, CA 94547-1838

Mailing address

500 Alfred Nobel Dr
Hercules, CA 94547-1838

Other identifiers

IdentifierTypeStateIssuer
1801356787OtherCAMEDICAL

Other providers in Hercules, CA

All providers in Hercules, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.