MEDICARE: ANN CHRISTINE PASTOR

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1093238677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN CHRISTINE PASTOR

Provider Business Mailing Address
First Line	:	1849 MYSTIC DR
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-9015
Country	:	US
Telephone Number	:	707-290-8252
Fax Number	:

Provider Business Practice Location Address
First Line	:	1849 MYSTIC DR
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-9015
Country	:	US
Telephone Number	:	707-290-8252
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2017
Last Update Date	:	07/21/2022

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Directions to “ ANN CHRISTINE PASTOR ” Practice Location

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