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Individual
MR. TRAVIS KINCAID
Active
Individual
MR. TRAVIS KINCAID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1423090321
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1625830725
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RH0017280426
CA
106S00000X
Behavior Technician
Primary
—
—
172V00000X
Community Health Worker
—
CA
175T00000X
Peer Specialist
MPSS-JKYHOE
CA
175T00000X
Peer Specialist
MPSS-JKYHQE
CA
Other
Enumeration date
02/10/2021
Last updated
04/14/2026
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