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General NPI Number Information
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NPI Number | 1114866142
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Entity Type | Individual
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Provider Name | KRYSTIN NASHE DEBOSE
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Gender | Female
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 1320 WILLOW PASS RD STE 628
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City | CONCORD
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State | CA
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Zip | 94520-5232
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Country | US
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Telephone | 503-780-0292
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Fax | 503-296-5396
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Provider Business Mailing Address
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Address Line | 1027 MEPHAM DR
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City | PITTSBURG
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State | CA
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Zip | 94565-3771
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Country | US
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Telephone | 341-688-9129
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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 |
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