Provider Demographics
NPI:1194561167
Name:STRONG, RAYNE MORGAN (RBT)
Entity type:Individual
Prefix:
First Name:RAYNE
Middle Name:MORGAN
Last Name:STRONG
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:RAYNE
Other - Middle Name:MORGAN
Other - Last Name:BUCKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:425 W BEECH ST UNIT 1458
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-8437
Mailing Address - Country:US
Mailing Address - Phone:909-910-1668
Mailing Address - Fax:
Practice Address - Street 1:425 W BEECH ST UNIT 1458
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-8437
Practice Address - Country:US
Practice Address - Phone:909-910-1668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician