Most Relevant Information
Provider Data
| NPI Number: | 1003510942 |
| Provider Name: | KESANET NUGUSE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/27/2023 |
| Last Updated: | 03/27/2023 |
Provider Practice Location
2017 CONSTITUTION CT
SAN LEANDRO
CA
945791983
Practice Location Phone/Fax
| Phone: | 5106263070 |
| Fax: |
Provider Mailing Location
1880 FAIRWAY DR
SAN LEANDRO
CA
945775629
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |