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General NPI Number Information
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NPI Number | 1114852076
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Entity Type | Individual
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Provider Name | AMBROSE MATHENY
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Gender | Male
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Dates
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Enumeration Date | 06/15/2026
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 8834 MORRO RD
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City | ATASCADERO
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State | CA
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Zip | 93422-3953
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Country | US
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Telephone | 805-466-7827
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Fax | 866-317-1665
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Provider Business Mailing Address
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Address Line | 903 AMBROSIA LN
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-7848
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Country | US
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Telephone | 615-454-8428
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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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