Shantoria Shanae Thompson

Individual provider Active NPI Behavior Technician · Oakland, CA

NPI 1770048472 · NPPES record last updated Feb 6, 2019

Key facts

NPI
1770048472
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1999 Harrison St Ste 1800
Oakland, CA 94612-4700
Phone
(916) 720-3098
NPI assigned
Feb 6, 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 Yes

Addresses

Primary practice location

1999 Harrison St Ste 1800
Oakland, CA 94612-4700

Mailing address

1023 75TH Ave
Oakland, CA 94621-2913
Phone (510) 880-9910

Other providers in Oakland, CA

All providers in Oakland, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.