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NPI Code Detail

MEDICARE: BRITTANY TYLER

MEDICARE:   BRITTANY  TYLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106E00000XAssistant Behavior Analyst

General Provider Information

NPI Number : 1134667660
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY TYLER
Provider Business Mailing Address
First Line : PO BOX 720072
Second Line :
City : SAN DIEGO
State : CA
Zip : 92172-0072
Country : US
Telephone Number : 858-603-9835
Fax Number :
Provider Business Practice Location Address
First Line : 625 PENNSYLVANIA AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-4321
Country : US
Telephone Number : 858-603-9835
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2017
Last Update Date : 02/03/2017

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Directions to “ BRITTANY TYLER ” Practice Location

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