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NPI Code Detail

MEDICARE: CODY CARLIN RBT

MEDICARE: CODY CARLIN RBT
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 Technician15-02815CA

General Provider Information

NPI Number : 1417465956
Entity Type Code : Individual
Provider Name (Legal Business Name) : CODY CARLIN RBT
Provider Business Mailing Address
First Line : 2404 F ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-2025
Country : US
Telephone Number : 619-493-0077
Fax Number :
Provider Business Practice Location Address
First Line : 2404 F ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-2025
Country : US
Telephone Number : 619-493-0077
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2018
Last Update Date : 02/03/2026

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Directions to “ CODY CARLIN RBT” Practice Location

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