Healthcare Provider Details

I. General information

NPI: 1851030712
Provider Name (Legal Business Name): REINA KAY KOWALSKI BT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 GARDEN RD STE 280
MONTEREY CA
93940-5374
US

IV. Provider business mailing address

610 MONTEREY RD
SEASIDE CA
93955-6301
US

V. Phone/Fax

Practice location:
  • Phone: 831-220-0739
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: