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Evandro Cassoma

Behavior Technician in Oakland, CA. Individual provider (NPI-1).

NPI number1962043794
StatusActive
Last updated in NPPESOct 2, 2019

Details

NPI
1962043794
Entity type
Individual (NPI-1)
Name
Evandro Cassoma
Sex
Male
Sole proprietor
No
Enumeration date
Oct 2, 2019
Last updated
Oct 2, 2019

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 codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician––Yes

Practice location

400 29th St Ste 204
Oakland, CA 94609-3547

Phone 510-679-3545

Mailing address

24488 Mohr Dr
Hayward, CA 94545-1914

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.

Other Behavior Technician providers in Oakland, CA

All 935 Behavior Technician providers in Oakland · All 20,942 providers in Oakland

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