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NPI Code Detail

MEDICARE: KAITLYN M GROSS

MEDICARE: KAITLYN M GROSS
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 : 1689521767
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYN M GROSS
Provider Business Mailing Address
First Line : 3186 AIRWAY AVE STE A
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-4650
Country : US
Telephone Number : 714-881-0427
Fax Number :
Provider Business Practice Location Address
First Line : 3186 AIRWAY AVE STE A
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-4650
Country : US
Telephone Number : 714-881-0427
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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Directions to “ KAITLYN M GROSS ” Practice Location

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