IndividualActive
Dylan Hackett-Provenzano
NPI 1063119741 · Behavior Technician · Stockton, CA
Dylan Hackett-Provenzano is a Behavior Technician provider in Stockton, CA (NPI 1063119741).
Provider details
- NPI number
- 1063119741
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(52/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1811 Grand Canal Blvd
Stockton, CA 95207-8155
Phone: (877) 418-2978
Street-level locationGet directions
Mailing address
1156 W Mendocino Ave
Stockton, CA 95204-3026
Registry dates
- Enumerated
- 2023-02-13
- Last updated
- 2023-02-13
- Certified
- 2023-02-13
Frequently asked questions
- What is Dylan Hackett-Provenzano's NPI number?
- Dylan Hackett-Provenzano's National Provider Identifier (NPI) is 1063119741, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Dylan Hackett-Provenzano's specialty?
- Dylan Hackett-Provenzano is listed in the NPPES registry with a primary specialty of Behavior Technician (Behavioral Health & Social Service Providers).
- Where is Dylan Hackett-Provenzano located?
- Dylan Hackett-Provenzano's practice location on file with NPPES is 1811 Grand Canal Blvd, Stockton, CA 95207-8155.
- What is Dylan Hackett-Provenzano's phone number?
- The practice phone number listed in the NPPES registry for Dylan Hackett-Provenzano is (877) 418-2978.
- Is Dylan Hackett-Provenzano's NPI active?
- Yes — Dylan Hackett-Provenzano's NPI (1063119741) is active in the NPPES registry as of the last update on 2023-02-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.