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NPI Code Detail

MEDICARE: JOSEPH DEGROS

MEDICARE: JOSEPH DEGROS
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1134958598
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH DEGROS
Provider Business Mailing Address
First Line : 1333 S MAYFLOWER AVE
Second Line : SUITE 220
City : MONROVIA
State : CA
Zip : 91016-4066
Country : US
Telephone Number : 818-241-6780
Fax Number : 888-588-2752
Provider Business Practice Location Address
First Line : 24 ALBION RD
Second Line : SUITE 320
City : LINCOLN
State : RI
Zip : 02865-3746
Country : US
Telephone Number : 855-295-3276
Fax Number : 888-588-2752
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2024
Last Update Date : 11/06/2024

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Directions to “ JOSEPH DEGROS ” Practice Location

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