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NPI Code Detail

MEDICARE: KHERMAEL ADAMS

MEDICARE: KHERMAEL ADAMS
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 : 1669366415
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHERMAEL ADAMS
Provider Business Mailing Address
First Line : 100 N PACIFIC COAST HWY STE 1400
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-5602
Country : US
Telephone Number : 310-856-0800
Fax Number :
Provider Business Practice Location Address
First Line : 560 E HOSPITALITY LN STE 400
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92408-3545
Country : US
Telephone Number : 443-430-7570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2025
Last Update Date : 06/16/2026

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Directions to “ KHERMAEL ADAMS ” Practice Location

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