Healthcare Provider Details

I. General information

NPI: 1760347587
Provider Name (Legal Business Name): EARLENA GREER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 N GOLD CANYON ST APT A
RIDGECREST CA
93555-1134
US

IV. Provider business mailing address

340 N GOLD CANYON ST APT A
RIDGECREST CA
93555-1134
US

V. Phone/Fax

Practice location:
  • Phone: 760-677-5307
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: