Nicolas Armand Caruso
Individual provider Active NPI Behavior Technician · Marina, CA
NPI 1548022650 · NPPES record last updated Jan 24, 2024
Key facts
- NPI
- 1548022650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- 00012633 (CA)
- Practice address
- 3116 Lake Dr Apt 41
Marina, CA 93933-2837 - Phone
- (707) 775-9994
- NPI assigned
- Jan 24, 2024
- Sex
- Male
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00012633 | CA | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 00012633 | CA | Yes |
Addresses
Primary practice location
3116 Lake Dr Apt 41
Marina, CA 93933-2837
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Other providers in Marina, CA
- Lellivi Sanchez Carmen
- Laura Jean Carroll
- Bradley Warren Carson
- Bethany Marie Carter
- Megan Elisabeth Carter
- Amber Jean Castagna
- Ramiro Castellon de la O
- Brittany Castillo
- Stephanie Cazarez
- Victoria Cervantes
All providers in Marina, CA · Behavior Technician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 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.