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NPI Code Detail

MEDICARE: ALLISON FANYA GREEN

MEDICARE: ALLISON FANYA GREEN
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 TechnicianCA

General Provider Information

NPI Number : 1154286391
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON FANYA GREEN
Provider Business Mailing Address
First Line : 25769 BARNETT LN
Second Line :
City : STEVENSON RANCH
State : CA
Zip : 91381-1125
Country : US
Telephone Number : 661-312-6824
Fax Number :
Provider Business Practice Location Address
First Line : 28245 AVENUE CROCKER STE 220
Second Line :
City : VALENCIA
State : CA
Zip : 91355-1201
Country : US
Telephone Number : 661-254-7086
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2025
Last Update Date : 12/19/2025

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Directions to “ ALLISON FANYA GREEN ” Practice Location

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