Most Relevant Information
Provider Data
| NPI Number: | 1003401555 |
| Provider Name: | GREGORY NOAH THEODORE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/06/2021 |
| Last Updated: | 03/06/2021 |
Provider Practice Location
1922 THE ALAMEDA STE 425
SAN JOSE
CA
951261453
Practice Location Phone/Fax
| Phone: | 8665234268 |
| Fax: |
Provider Mailing Location
PO BOX 399318
SAN FRANCISCO
CA
941399318
Provider Mailing Phone/Fax
| Phone: | 8665234268 |
| Fax: |