Lucky Erentreich
Behavior Technician in San Diego, CA. Individual provider (NPI-1).
NPI number1114558657
StatusActive
Last updated in NPPESFeb 3, 2020
Details
- NPI
- 1114558657
- Entity type
- Individual (NPI-1)
- Name
- Lucky Erentreich
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 3, 2020
- Certification date
- Feb 3, 2020
- Last updated
- Feb 3, 2020
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 code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
8885 Rio San Diego Dr Ste 340San Diego, CA 92108-1669
Phone 619-795-9925
Mailing address
8885 Rio San Diego Dr Ste 340San Diego, CA 92108-1669
Phone 619-795-9925
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.
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