MEDICARE: ALYNAH ALISSA OVIEDO BS, 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

General Provider Information

NPI Number	:	1922717545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYNAH ALISSA OVIEDO BS, RBT

Provider Business Mailing Address
First Line	:	8150 BRAMPTON ST
Second Line	:
City	:	SPRING VALLEY
State	:	CA
Zip	:	91977-3706
Country	:	US
Telephone Number	:	619-750-2588
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 N VULCAN AVE STE 208
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-2191
Country	:	US
Telephone Number	:	760-634-1125
Fax Number	:

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

Provider Enumeration Date	:	11/22/2022
Last Update Date	:	11/22/2022

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