Charles Anderson

Individual provider Active NPI Behavior Technician · Burlingame, CA

NPI 1922629633 · NPPES record last updated May 4, 2020

Key facts

NPI
1922629633
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1350 Old Bayshore Hwy
Burlingame, CA 94010-1823
Phone
(855) 295-3276
Fax
(818) 241-6853
NPI assigned
May 4, 2020
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)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

1350 Old Bayshore Hwy
Burlingame, CA 94010-1823

Mailing address

1055 E Colorado Blvd Ste 560
Pasadena, CA 91106-2380

Other providers in Burlingame, CA

All providers in Burlingame, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.