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Mia Marie Kellner

Behavior Technician in Walnut Creek, CA. Individual provider (NPI-1).

NPI number1013672369
StatusActive
Last updated in NPPESNov 2, 2021

Details

NPI
1013672369
Entity type
Individual (NPI-1)
Name
Mia Marie Kellner
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 2, 2021
Certification date
Nov 2, 2021
Last updated
Nov 2, 2021

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician––Yes

Practice location

800 S Broadway Ste 310
Walnut Creek, CA 94596-5218

Phone 925-264-1902

Mailing address

800 S Broadway Ste 310
Walnut Creek, CA 94596-5218

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Behavior Technician providers in Walnut Creek, CA

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