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NPI Code Detail

MEDICARE: EZEQUIEL ECHEVERRIA

MEDICARE: EZEQUIEL ECHEVERRIA
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 : 1548129216
Entity Type Code : Individual
Provider Name (Legal Business Name) : EZEQUIEL ECHEVERRIA
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 : 1855 2ND ST STE B
Second Line :
City : CONCORD
State : CA
Zip : 94519-2623
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2026
Last Update Date : 01/19/2026

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Directions to “ EZEQUIEL ECHEVERRIA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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