Kassandra Judyth Chacon
Behavior Technician in Carlsbad, CA. Individual provider (NPI-1).
NPI number1063294635
StatusActive
Last updated in NPPESOct 18, 2023
Details
- NPI
- 1063294635
- Entity type
- Individual (NPI-1)
- Name
- Kassandra Judyth Chacon
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 18, 2023
- Certification date
- Oct 18, 2023
- Last updated
- Oct 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
5870 El Camino RealCarlsbad, CA 92008-8816
Phone 760-539-5818
Mailing address
4302 Wind River WayOceanside, CA 92057-6509
Phone 760-445-7115
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