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

Etty Buana

Individual provider Behavior Technician · NPI 1093524910

Etty Buana is a Behavior Technician in Fremont, California. Licensed in California. Registered with an NPI since 2025.

Licensed in
CA
In the registry since
2025

Practice location Address checks out

39210 State St Ste 220
Fremont, CA 94538-1456
Phone: (510) 894-4135
Show map & directions

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

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X · Licence 46-1305562 (CA)

Record details

NPI number1093524910
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 6, 2025
Last updated in NPPESJanuary 6, 2025
Certification dateJanuary 6, 2025
Mailing address8 Rotunda Ave, Essex Jct, VT 05452-3014

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