Etty Buana
Behavior Technician in Fremont, California
1093524910- Practice location
- 39210 State St Ste 220, Fremont, CA 94538-1456
- Phone
- 510-894-4135
- Fax
- —
- Last updated
- January 6, 2025
Etty Buana is a Behavior Technician based in Fremont, CA. Etty Buana practices in Fremont, CA. The NPI Number for Etty Buana is 1093524910 and holds a License No. 46-1305562 (CA). The current practice location address for Etty Buana is 39210 State St Ste 220, Fremont, CA 94538-1456 and can be reached out via phone at 510-894-4135.
Provider Profile Details
- NPI Number
- 1093524910
- Provider Name
- Etty Buana
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 39210 State St Ste 220, Fremont, CA 94538-1456
- Phone Number
- 510-894-4135
- Primary Taxonomy
- Behavior Technician · 106S00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- January 6, 2025
- Last Update Date
- January 6, 2025
- Certification Date
- January 6, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 39210 State St Ste 220
Fremont, CA 94538-1456 - City
- Fremont
- State
- California
- Zip
- 94538-1456
- Phone Number
- 510-894-4135
Provider Business Mailing Address Details
- Address
- 8 Rotunda Ave
Essex Jct, VT 05452-3014 - City
- Essex Jct
- State
- VT
- Zip
- 05452-3014
- Phone Number
- 802-503-4808
License Information
- License Number
- 46-1305562
- License State
- CA
- Taxonomy
- Behavior Technician · 106S00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Behavior Technicians near Fremont, CA
View all Behavior Technicians in Fremont →Frequently Asked Questions
What is the NPI number of Etty Buana?
The NPI number of Etty Buana is 1093524910. It was assigned on January 6, 2025 and is currently active in the NPPES registry.
What is the specialty of Etty Buana?
Etty Buana is registered under the primary taxonomy Behavior Technician (code 106S00000X), licensed in CA under license number 46-1305562.
Where does Etty Buana practice?
The practice location is 39210 State St Ste 220, Fremont, CA 94538-1456. The office can be reached at 510-894-4135 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1093524910 directly on the NPPES registry website.