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NPI Code Detail

MEDICARE: DEVONNA BERRY

MEDICARE: DEVONNA BERRY
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 : 1578413886
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVONNA BERRY
Provider Business Mailing Address
First Line : 2105 FRANKLIN AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95204-4807
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2105 FRANKLIN AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95204-4807
Country : US
Telephone Number : 209-298-7898
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2026
Last Update Date : 01/28/2026

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Directions to “ DEVONNA BERRY ” Practice Location

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