Healthcare Provider Details

I. General information

NPI: 1477419760
Provider Name (Legal Business Name): RAEANN FURBUSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 AIRPORT RD
OCEANSIDE CA
92058-1201
US

IV. Provider business mailing address

251 AIRPORT RD
OCEANSIDE CA
92058-1201
US

V. Phone/Fax

Practice location:
  • Phone: 760-547-1381
  • Fax: 858-695-9412
Mailing address:
  • Phone: 760-547-1381
  • Fax: 858-695-9412

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: