Jonathan Peter Broadhurst
Individual provider Active NPI Behavior Technician · Arcata, CA
NPI 1790249407 · NPPES record last updated Jan 27, 2019
Key facts
- NPI
- 1790249407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 901 O St Ste C
Arcata, CA 95521-5789 - Phone
- (707) 497-9335
- NPI assigned
- Jan 27, 2019
- Sex
- Male
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
901 O St Ste C
Arcata, CA 95521-5789
Mailing address
2109 11TH St
Arcata, CA 95521-5408
Other providers in Arcata, CA
- Lucia Agnes Brazier-Obannion
- Joseph T. Breen
- Annette Breshears-McLean
- Jenoa Briar-Bonpane
- Kevin L Brink
- Dayna L Brockman
- Amy P. Brom
- Carrie R. K. Brothers
- Adam Brown
- Bridget Brown
All providers in Arcata, CA · Behavior Technician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.