Melissa Kiyo Broberg
Behavior Technician in Stanton, CA. Individual provider (NPI-1).
NPI number1982164505
StatusActive
Last updated in NPPESMar 20, 2019
Details
- NPI
- 1982164505
- Entity type
- Individual (NPI-1)
- Name
- Ms. Melissa Kiyo Broberg
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 20, 2019
- Last updated
- Mar 20, 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 code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
12235 Beach BlvdStanton, CA 90680-3939
Phone 714-202-0118
Mailing address
16825 Pembrook LnHuntington Beach, CA 92649-6022
Phone 714-606-3885
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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All 250 Behavior Technician providers in Stanton · All 581 providers in Stanton
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