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NPI Code Detail

MEDICARE: SAMANTHA KERANS

MEDICARE: SAMANTHA KERANS
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 : 1205420700
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA KERANS
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 : 1600 W CHANDLER BLVD STE 180
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-6164
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2021
Last Update Date : 09/21/2025

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Directions to “ SAMANTHA KERANS ” Practice Location

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