MEDICARE: ALICIA CARRIZALES

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		ID

General Provider Information

NPI Number	:	1548127293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA CARRIZALES

Provider Business Mailing Address
First Line	:	220 W GEORGIA AVE
Second Line	:
City	:	NAMPA
State	:	ID
Zip	:	83686-2835
Country	:	US
Telephone Number	:	208-960-7474
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 W GEORGIA AVE
Second Line	:
City	:	NAMPA
State	:	ID
Zip	:	83686-2835
Country	:	US
Telephone Number	:	208-960-7474
Fax Number	:

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

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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Directions to “ ALICIA CARRIZALES ” Practice Location

Language	Start Address	Practice Location

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