Victor Amezcua

Individual provider Active NPI Behavior Technician · Camarillo, CA

NPI 1558092387 · NPPES record last updated Jun 22, 2022

Key facts

NPI
1558092387
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1305 Del Norte Rd
Camarillo, CA 93010-8436
Phone
(805) 654-9814
NPI assigned
Jun 22, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Cosmic Care ABA Behavior Technician Past
since Jun 26, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

1305 Del Norte Rd
Camarillo, CA 93010-8436

Mailing address

1305 Del Norte Rd
Camarillo, CA 93010-8436

Other identifiers

IdentifierTypeStateIssuer
F7368502OtherCADRIVER LICENSE

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address vamezcua@sageservices.org Direct

Other providers in Camarillo, CA

All providers in Camarillo, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.