Shawnee Banuelos

Individual provider Active NPI Behavior Technician · Placentia, CA

NPI 1700429024 · NPPES record last updated Oct 18, 2019

Key facts

NPI
1700429024
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
701 W Kimberly Ave Ste 245
Placentia, CA 92870-6345
Phone
(714) 780-2282
NPI assigned
Oct 18, 2019
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

701 W Kimberly Ave Ste 245
Placentia, CA 92870-6345

Mailing address

321 Bishop Dr
La Habra, CA 90631-2901

Other providers in Placentia, CA

All providers in Placentia, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.