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NPI Code Detail

MEDICARE: MEGUMI WANTANABE

MEDICARE: MEGUMI WANTANABE
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 : 1669305983
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGUMI WANTANABE
Provider Business Mailing Address
First Line : 850 TOWBIN AVE
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-5928
Country : US
Telephone Number : 833-599-2560
Fax Number :
Provider Business Practice Location Address
First Line : 3745 LONG BEACH BLVD STE 100
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-3340
Country : US
Telephone Number : 866-523-4268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2026
Last Update Date : 06/05/2026

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Directions to “ MEGUMI WANTANABE ” Practice Location

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