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NPI Code Detail

MEDICARE: SHELLI LYNNE RICH

MEDICARE: SHELLI LYNNE RICH
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 TechnicianCA

General Provider Information

NPI Number : 1932830122
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLI LYNNE RICH
Provider Business Mailing Address
First Line : 350 FAIRWAY DR STE 101
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1834
Country : US
Telephone Number : 888-880-9270
Fax Number : 866-500-2186
Provider Business Practice Location Address
First Line : 15233 VENTURA BLVD STE 500
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91403-2231
Country : US
Telephone Number : 888-880-9270
Fax Number : 866-500-2186
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2022
Last Update Date : 12/10/2025

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