Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Deric Ryan Kettwig

Individual provider Behavior Technician · NPI 1508581794

Deric Ryan Kettwig is a Behavior Technician in Costa Mesa, California. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

3151 Airway Ave Ste P3
Costa Mesa, CA 92626-4626
Phone: (949) 694-7172
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1508581794
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 10, 2022
Last updated in NPPESOctober 10, 2022
Certification dateOctober 10, 2022
Mailing address378 N 475 W, Valparaiso, IN 46385-9228

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