Gage Black
Individual provider Active NPI Behavior Technician · Olivehurst, CA
NPI 1801768304 · NPPES record last updated Sep 23, 2025
Key facts
- NPI
- 1801768304
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 1542 9TH Ave
Olivehurst, CA 95961-4404 - Phone
- (530) 799-7056
- NPI assigned
- Sep 23, 2025
- 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
1542 9TH Ave
Olivehurst, CA 95961-4404
Mailing address
1075 Creekside Ridge Dr Ste 280
Roseville, CA 95678-3504
Other providers in Olivehurst, CA
- Ximena Alvarado Chimal
- Belquis Amani
- Gary R. Amatangelo
- Ampla Health
- Ampla Health
- Hector Camacho
- Jazmine Cancel
- Gerardo Antonio Castillo
- Anayeli Chavez
- Brizeida Chavez
All providers in Olivehurst, 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 Sep 23, 2025. 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.