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NPI Code Detail

MEDICARE: ANTHONY BERRIOS

MEDICARE: ANTHONY BERRIOS
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
2225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1679228985
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY BERRIOS
Provider Business Mailing Address
First Line : 1333 S MAYFLOWER AVE STE 220
Second Line :
City : MONROVIA
State : CA
Zip : 91016-4066
Country : US
Telephone Number : 323-745-7734
Fax Number :
Provider Business Practice Location Address
First Line : 320 N MADISON AVE STE B
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-3791
Country : US
Telephone Number : 323-644-2026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2022
Last Update Date : 05/04/2022

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Directions to “ ANTHONY BERRIOS ” Practice Location

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