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NPI Code Detail

MEDICARE: MEGAN EILEEN ADDIEGO-HUTTON

MEDICARE: MEGAN EILEEN ADDIEGO-HUTTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystCA

General Provider Information

NPI Number : 1063921567
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN EILEEN ADDIEGO-HUTTON
Provider Business Mailing Address
First Line : 350 FAIRWAY DR STE 101
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1834
Country : US
Telephone Number : 877-418-2978
Fax Number : 866-500-2186
Provider Business Practice Location Address
First Line : 1811 GRAND CANAL BLVD STE 2
Second Line :
City : STOCKTON
State : CA
Zip : 95207-8107
Country : US
Telephone Number : 925-596-3235
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2017
Last Update Date : 01/05/2026

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