IndividualActive
Patric Phanouvong
NPI 1669189965 · Behavior Technician · Stockton, CA
Patric Phanouvong is a Behavior Technician provider in Stockton, CA (NPI 1669189965).
Provider details
- NPI number
- 1669189965
- 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(53/100 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 Suite 2 Stockton, Ca 95207
Stockton, CA 95207
Phone: (877) 418-2978
Fax: (866) 500-2186
Street-level locationGet directions
Mailing address
350 Fairway Dr Ste 101
Deerfield Beach, FL 33441-1834
Registry dates
- Enumerated
- 2022-11-04
- Last updated
- 2022-11-04
- Certified
- 2022-11-04
Frequently asked questions
- What is Patric Phanouvong's NPI number?
- Patric Phanouvong's National Provider Identifier (NPI) is 1669189965, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Patric Phanouvong's specialty?
- Patric Phanouvong is listed in the NPPES registry with a primary specialty of Behavior Technician (Behavioral Health & Social Service Providers).
- Where is Patric Phanouvong located?
- Patric Phanouvong's practice location on file with NPPES is 1811 Grand Canal Blvd Suite 2 Stockton, Ca 95207, Stockton, CA 95207.
- What is Patric Phanouvong's phone number?
- The practice phone number listed in the NPPES registry for Patric Phanouvong is (877) 418-2978.
- Is Patric Phanouvong's NPI active?
- Yes — Patric Phanouvong's NPI (1669189965) is active in the NPPES registry as of the last update on 2022-11-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.