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NPI Code Detail

MEDICARE: WENTRELLE MCINTOSH

MEDICARE: WENTRELLE MCINTOSH
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 : 1740658756
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENTRELLE MCINTOSH
Provider Business Mailing Address
First Line : 255 E RINCON ST STE 219
Second Line :
City : CORONA
State : CA
Zip : 92879-1387
Country : US
Telephone Number : 714-616-5735
Fax Number :
Provider Business Practice Location Address
First Line : 255 E RINCON ST STE 219
Second Line :
City : CORONA
State : CA
Zip : 92879-1387
Country : US
Telephone Number : 714-834-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2015
Last Update Date : 10/08/2024

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Directions to “ WENTRELLE MCINTOSH ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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