Provider Demographics
NPI:1891030920
Name:GARIBAY-ESCOBEDO, MICHELLE VIVIANE (BEHAVIOR TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:VIVIANE
Last Name:GARIBAY-ESCOBEDO
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 BANCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-4528
Mailing Address - Country:US
Mailing Address - Phone:510-499-2645
Mailing Address - Fax:
Practice Address - Street 1:4240 BANCROFT AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-4528
Practice Address - Country:US
Practice Address - Phone:510-499-2645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician