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NPI Code Detail

MEDICARE: MICHELLE TAPIA TAPIA TRUEBA

MEDICARE:   MICHELLE TAPIA TAPIA TRUEBA
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 : 1790369395
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE TAPIA TAPIA TRUEBA
Provider Business Mailing Address
First Line : 3914 MURPHY CANYON RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-4491
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7542 CENTRAL AVE
Second Line :
City : LEMON GROVE
State : CA
Zip : 91945-2304
Country : US
Telephone Number : 619-335-6334
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2021
Last Update Date : 05/10/2021

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Directions to “ MICHELLE TAPIA TAPIA TRUEBA ” Practice Location

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