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NPI Code Detail

MEDICARE: MIA ISABELLA ACOSTA

MEDICARE: MIA ISABELLA ACOSTA
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1265246441
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIA ISABELLA ACOSTA
Provider Business Mailing Address
First Line : 4508 N SIERRA WAY
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92407-3854
Country : US
Telephone Number : 800-207-0272
Fax Number :
Provider Business Practice Location Address
First Line : 4508 N SIERRA WAY
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92407-3854
Country : US
Telephone Number : 800-207-0272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2025
Last Update Date : 10/28/2025

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Directions to “ MIA ISABELLA ACOSTA ” Practice Location

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