Carl-Marvin Kenneth-Elijah Wright

Individual provider Active NPI Behavior Technician · National City, CA

NPI 1609600550 · NPPES record last updated Aug 30, 2024

Key facts

NPI
1609600550
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2423 Hoover Ave
National City, CA 91950-6619
Phone
(619) 739-4569
Fax
(877) 602-5087
NPI assigned
Aug 30, 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 CA Yes

Addresses

Primary practice location

2423 Hoover Ave
National City, CA 91950-6619

Mailing address

5252 Orange Ave Unit 316
San Diego, CA 92115-6034
Phone (619) 922-1178

Other providers in National City, CA

All providers in National City, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.