Most Relevant Information
Provider Data
| NPI Number: | 1003462912 |
| Provider Name: | KIANA VAN KREGTEN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/15/2019 |
| Last Updated: | 08/15/2019 |
Provider Practice Location
1025 ATLANTIC AVE STE 101
ALAMEDA
CA
945011188
Practice Location Phone/Fax
| Phone: | 5102688120 |
| Fax: |
Provider Mailing Location
258 CRONIN DR
SANTA CLARA
CA
950516724
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |