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NPI Code Detail

MEDICARE: AJA MARIE HATZIS

MEDICARE: AJA MARIE HATZIS
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 : 1922884501
Entity Type Code : Individual
Provider Name (Legal Business Name) : AJA MARIE HATZIS
Provider Business Mailing Address
First Line : 9904 PRAIRIE DUNES WAY
Second Line :
City : SACRAMENTO
State : CA
Zip : 95829-8013
Country : US
Telephone Number : 916-548-8039
Fax Number :
Provider Business Practice Location Address
First Line : 2368 MARITIME DR STE 260
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-3654
Country : US
Telephone Number : 916-676-0488
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2023
Last Update Date : 09/07/2023

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