Christian Gibson
Behavior Technician in Brentwood, CA. Individual provider (NPI-1).
NPI number1154036002
StatusActive
Last updated in NPPESJan 16, 2023
Details
- NPI
- 1154036002
- Entity type
- Individual (NPI-1)
- Name
- Christian Gibson
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 16, 2023
- Certification date
- Jan 16, 2023
- Last updated
- Jan 16, 2023
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
1191 Central Blvd Ste ABrentwood, CA 94513-2253
Phone 855-223-7123 · Fax 619-374-7134
Mailing address
16782 Von Karman Ave Ste 11Irvine, CA 92606-2417
Phone 855-223-7123 · Fax 619-374-7134
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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