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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KEENAN ELLIS

Active

Behavior Technician · DAVIS, CA

Registration Details

NPI Number
1518693761
Provider Type
Individual
Gender
Male
NPI Issued
Jul 29, 2022 (3.7488964864145 yrs)
Last Updated
Sep 26, 2022
Licenses
Y4620530 (CA)
Y4620530 (CA)

Practice Information

Address
1947 GALILEO CT STE 101
DAVIS, CA, 956184882
Browse CA providers · Browse ZIP 95618
Phone
1530220145
Primary Specialty
Behavior Technician
106S00000X
Additional Specialty
Behavior Technician

Other Behavior Technician Providers in DAVIS, CA

Name Credential NPI
URSULA STALLWORTH C.M.P 1720401185
RAYNALD DIZON 1407399637
CHAD CABRISTANTE 1821508052
NICHOLAS ANTHONY SPILKA 1710495643
SEDA BITTER 1487152443
ALIS MARTINEZ 1578061388
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.