=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396306072
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | OCIEL ALMONTE
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2019
-----------------------------------------------------
Last Update Date | 06/24/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5501 ANTIQUE ROSE WAY
-----------------------------------------------------
City | RIVERBANK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95367-9505
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-521-4791
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16300 HARMONY RANCH DR
-----------------------------------------------------
City | DELHI
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95315-9210
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-406-3072
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------