MEDICARE: JUSTICE CARTER RBT

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
1	106S00000X	Behavior Technician	RBT-25-451253	CA

General Provider Information

NPI Number	:	1316870066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTICE CARTER RBT

Provider Business Mailing Address
First Line	:	1330 CHARLES LN
Second Line	:
City	:	RAMONA
State	:	CA
Zip	:	92065-3321
Country	:	US
Telephone Number	:	414-520-8141
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 N VULCAN AVE STE 209
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-2191
Country	:	US
Telephone Number	:	414-520-8141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “ JUSTICE CARTER RBT” Practice Location

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