Mia Destiny Brito

Individual provider Active NPI Behavior Technician · Cypress, CA

NPI 1669201729 · NPPES record last updated Jul 29, 2024

Key facts

NPI
1669201729
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
5252 Orange Ave Ste 109
Cypress, CA 90630-2967
Phone
(657) 214-8014
NPI assigned
Jul 29, 2024
Sex
Female
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

5252 Orange Ave Ste 109
Cypress, CA 90630-2967

Mailing address

12702 Aristocrat Ave
Garden Grove, CA 92841-4634
Phone (714) 499-6368

Other names

  • Mia Destiny Brito Former name

Other providers in Cypress, CA

All providers in Cypress, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.