Destiny Nichole Vega

Individual provider Active NPI Behavior Technician · Avalon, CA

NPI 1750089140 · NPPES record last updated Feb 16, 2023

Key facts

NPI
1750089140
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
100 Banning Dr Apt B8
Avalon, CA 90704-1658
Phone
(310) 755-8469
NPI assigned
Feb 16, 2023
Sex
Female
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 Yes

Addresses

Primary practice location

100 Banning Dr Apt B8
Avalon, CA 90704-1658

Mailing address

PO Box 1658
Avalon, CA 90704-1658
Phone (310) 755-8469

Other providers in Avalon, CA

All providers in Avalon, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.