Provider Demographics
NPI:1457148058
Name:FOSTER, AUBREE
Entity type:Individual
Prefix:
First Name:AUBREE
Middle Name:
Last Name:FOSTER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 DIAMOND E DR
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-6413
Mailing Address - Country:US
Mailing Address - Phone:707-616-1049
Mailing Address - Fax:
Practice Address - Street 1:44374 PALM ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-3117
Practice Address - Country:US
Practice Address - Phone:760-835-6725
Practice Address - Fax:760-835-6725
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1560470524106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician