MEDICARE: SCOTT KINGSADA

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
2	103K00000X	Behavior Analyst		CA

General Provider Information

NPI Number	:	1346605730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT KINGSADA

Provider Business Mailing Address
First Line	:	95 3RD ST FL 2
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-3103
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

Provider Business Practice Location Address
First Line	:	95 3RD ST FL 2
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-3103
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

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

Provider Enumeration Date	:	12/29/2015
Last Update Date	:	09/12/2022

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Directions to “ SCOTT KINGSADA ” Practice Location

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