Rasanna Simonne Ambrose
Individual provider Active NPI Behavior Technician · Glendale, AZ
NPI 1528958444 · NPPES record last updated Oct 3, 2025
Key facts
- NPI
- 1528958444
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 7111 W Bell Rd Ste 101
Glendale, AZ 85308-8552 - Phone
- (855) 223-7123
- NPI assigned
- Jul 3, 2025
- 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
7111 W Bell Rd Ste 101
Glendale, AZ 85308-8552
Mailing address
PO Box 33568
San Diego, CA 92163-3568
Phone (855) 223-7123
Other practice location 1
12409 W Indian School Rd Ste B210
Avondale, AZ 85392-9505
Phone (855) 223-7123
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All providers in Glendale, AZ · Behavior Technician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2025. 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.