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NPI Code Detail

MEDICARE: MARY KAMENSKI BCBA

MEDICARE:   MARY  KAMENSKI  BCBA
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
1103K00000XBehavior Analyst1-16-24215CA

General Provider Information

NPI Number : 1255879722
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY KAMENSKI BCBA
Provider Business Mailing Address
First Line : 11650 IBERIA PL STE 130
Second Line :
City : SAN DIEGO
State : CA
Zip : 92128-2431
Country : US
Telephone Number : 858-264-5858
Fax Number :
Provider Business Practice Location Address
First Line : 11650 IBERIA PL STE 130
Second Line :
City : SAN DIEGO
State : CA
Zip : 92128-2431
Country : US
Telephone Number : 858-264-5858
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2017
Last Update Date : 09/24/2019

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Directions to “ MARY KAMENSKI BCBA” Practice Location

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