DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: AZURE CHAMPLAIN

MEDICARE: AZURE CHAMPLAIN
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
1106E00000XAssistant Behavior Analyst0134000142VA

General Provider Information

NPI Number : 1124472659
Entity Type Code : Individual
Provider Name (Legal Business Name) : AZURE CHAMPLAIN
Provider Business Mailing Address
First Line : PO BOX 33568
Second Line :
City : SAN DIEGO
State : CA
Zip : 92163-3568
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Provider Business Practice Location Address
First Line : 2928 JEFFERSON ST STE 100
Second Line :
City : CARLSBAD
State : CA
Zip : 92008-2374
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2016
Last Update Date : 04/23/2024

Similar Medicare Providers

1457539280 — ERIN WILL
Practice Location Address:
2928 JEFFERSON ST STE 100
CARLSBAD, CA
92008-2374
Practice Phone: 760-637-9996
Practice Fax:
1528204872 — GWENDOLYN ROSE MCGUIRE
Practice Location Address:
2928 JEFFERSON ST STE 100
CARLSBAD, CA
92008-2374
Practice Phone: 760-637-9996
Practice Fax:
1154626422 — PATRICIA ANNE NICHOLLS MSW
Practice Location Address:
2928 JEFFERSON ST STE 100
CARLSBAD, CA
92008-2374
Practice Phone: 760-637-9996
Practice Fax:
1144564824 — AMY DETWILER BCBA
Practice Location Address:
2928 JEFFERSON ST STE 100
CARLSBAD, CA
92008-2374
Practice Phone: 855-223-7123
Practice Fax: 619-374-7134
1285006346 — CAROLINA CASSIMIRO
Practice Location Address:
2928 JEFFERSON ST STE 100
CARLSBAD, CA
92008-2374
Practice Phone: 855-223-7123
Practice Fax:
1316304462 — GALEN ROEHM B.A.
Practice Location Address:
2928 JEFFERSON ST STE 100
CARLSBAD, CA
92008-2374
Practice Phone: 760-637-9996
Practice Fax:

Directions to “ AZURE CHAMPLAIN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.