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NPI Code Detail

MEDICARE: LAURA PALACIO RBT

MEDICARE: LAURA PALACIO 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-22-237393CA

General Provider Information

NPI Number : 1710660188
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA PALACIO RBT
Provider Business Mailing Address
First Line : 7027 CAMINO DEGRAZIA UNIT 208
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-7811
Country : US
Telephone Number : 619-727-3926
Fax Number :
Provider Business Practice Location Address
First Line : 7027 CAMINO DEGRAZIA
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-7811
Country : US
Telephone Number : 619-727-3926
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2023
Last Update Date : 08/10/2023

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Directions to “ LAURA PALACIO RBT” Practice Location

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