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General NPI Number Information
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NPI Number | 1689262404
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Entity Type | Individual
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Provider Name | MARCELLA DIGEL
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Gender | Female
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Dates
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Enumeration Date | 01/07/2021
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 751 CAMINO PLZ SUITE A
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City | SAN BRUNO
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State | CA
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Zip | 94066-3401
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Country | US
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Telephone | 303-989-8169
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 EL CAMINO REAL APT 2
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City | BURLINGAME
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State | CA
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Zip | 94010-4845
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Country | US
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Telephone | 650-430-4140
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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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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-24-72833
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License Number State | CA
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