Provider Demographics
NPI:1891510699
Name:METZ, AVRIANNA NICOLE
Entity type:Individual
Prefix:
First Name:AVRIANNA
Middle Name:NICOLE
Last Name:METZ
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9187 CLAIREMONT MESA BLVD # 6-417
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1257
Mailing Address - Country:US
Mailing Address - Phone:530-927-9407
Mailing Address - Fax:
Practice Address - Street 1:6160 CORNERSTONE CT E
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3720
Practice Address - Country:US
Practice Address - Phone:858-304-6440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician