Lissette Alcantar

Individual provider Active NPI Behavior Technician · Clovis, CA

NPI 1760028211 · NPPES record last updated Nov 20, 2019

Key facts

NPI
1760028211
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
75 Park Creek Dr Ste 104
Clovis, CA 93611-4432
Phone
(559) 460-9090
NPI assigned
Nov 20, 2019
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 CA Yes

Addresses

Primary practice location

75 Park Creek Dr Ste 104
Clovis, CA 93611-4432

Mailing address

21600 Oxnard St Ste 1800
Woodland Hills, CA 91367-7807
Phone (818) 345-2345

Other providers in Clovis, CA

All providers in Clovis, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.