Active NPI
Efrain Vazquez
- Behavior Technician
- Worcester, MA
National Provider Identifier
1003204363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 345A Greenwood St
Worcester, MA 01607-1753 - Phone
- (508) 363-0200
- NPI assigned
- Jan 8, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
345A Greenwood St
Worcester, MA 01607-1753
Mailing address
345A Greenwood St
Worcester, MA 01607-1753
Phone (508) 363-0200
Other practice location 1
255 High St
Holyoke, MA 01040-6513
Phone (413) 322-7380
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1307576 | Medicaid | MA | |
| M18463 | Other | MA | BLUE CROSS BLUE SHIELD |
| 1303295 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621468800000",
"number": "1003204363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345A GREENWOOD ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016071753",
"telephone_number": "508-363-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345A GREENWOOD ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016071753",
"telephone_number": "508-363-0200"
}
],
"practiceLocations": [
{
"address_1": "255 High St",
"address_purpose": "LOCATION",
"city": "Holyoke",
"state": "MA",
"postal_code": "010406513",
"country_code": "US",
"telephone_number": "413-322-7380",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAZQUEZ",
"first_name": "EFRAIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-08",
"last_updated": "2021-05-20",
"certification_date": "2021-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1307576",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "M18463",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1303295",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.