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General NPI Number Information
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NPI Number | 1023950144
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Entity Type | Individual
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Provider Name | SHANE NEIL JOSEPH
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Gender | Male
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 5065 DEER VALLEY RD STE 243
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City | ANTIOCH
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State | CA
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Zip | 94531-5200
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Country | US
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Telephone | 925-538-1754
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Fax |
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Provider Business Mailing Address
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Address Line | 7251 BRENTWOOD BLVD
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City | BRENTWOOD
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State | CA
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Zip | 94513-2079
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Country | US
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Telephone | 925-539-9278
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | CA
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