Kieran Wallace
Behavior Technician in Santa Cruz, CA. Individual provider (NPI-1).
NPI number1184530446
StatusActive
Last updated in NPPESAug 19, 2026
Details
- NPI
- 1184530446
- Entity type
- Individual (NPI-1)
- Name
- Kieran Wallace
- Sole proprietor
- No
- Enumeration date
- Aug 19, 2026
- Certification date
- Aug 19, 2026
- Last updated
- Aug 19, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
101 Cooper StSanta Cruz, CA 95060-4526
Phone 877-264-6747
Mailing address
295 89th St Ste 306Daly City, CA 94015-1656
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All 772 Behavior Technician providers in Santa Cruz · All 5,733 providers in Santa Cruz
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