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NPI Code Detail

MEDICARE: ISAAC TEJEDA RBT

MEDICARE: ISAAC TEJEDA 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 TechnicianRBT-23-295861CA

General Provider Information

NPI Number : 1659105393
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISAAC TEJEDA RBT
Provider Business Mailing Address
First Line : 32107 LINDERO CANYON RD STE 229
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91361-4266
Country : US
Telephone Number : 818-851-9213
Fax Number : 818-855-7058
Provider Business Practice Location Address
First Line : 32107 LINDERO CANYON RD STE 229
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91361-4266
Country : US
Telephone Number : 818-851-9213
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2024
Last Update Date : 08/27/2024

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Directions to “ ISAAC TEJEDA RBT” Practice Location

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