Kevin Blankenship
Behavior Technician in Tracy, CA. Individual provider (NPI-1).
NPI number1164086997
StatusActive
Last updated in NPPESApr 26, 2019
Details
- NPI
- 1164086997
- Entity type
- Individual (NPI-1)
- Name
- Kevin Blankenship
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 26, 2019
- Last updated
- Apr 26, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | CA | Yes |
Practice location
510 Whispering Wind Dr Ste 110Tracy, CA 95377-8119
Phone 209-832-7756 · Fax 209-832-7942
Mailing address
Po Box 5157Modesto, CA 95352-5157
Phone 209-572-2589 · Fax 209-572-1461
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