Active NPI
Kalvin K Sirisukarn
- Behavior Technician
- Fresno, CA
National Provider Identifier
1013519768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 5653 N. Fresno St.
105
Fresno, CA 93710 - Phone
- (877) 418-2978
- Fax
- (866) 500-2186
- NPI assigned
- Nov 9, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | CA | Primary |
Addresses
Primary practice location
5653 N. Fresno St.
105
Fresno, CA 93710
Mailing address
5653 N. Fresno St.
105
Fresno, CA 93710
Phone (877) 418-2978
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": "1604880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604880000000",
"number": "1013519768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5653 N. FRESNO ST.",
"address_2": "105",
"city": "FRESNO",
"state": "CA",
"postal_code": "93710",
"telephone_number": "877-418-2978",
"fax_number": "866-500-2186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5653 N. FRESNO ST.",
"address_2": "105",
"city": "FRESNO",
"state": "CA",
"postal_code": "93710",
"telephone_number": "877-418-2978",
"fax_number": "866-500-2186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIRISUKARN",
"first_name": "KALVIN",
"middle_name": "K",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-09",
"last_updated": "2020-11-09",
"certification_date": "2020-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.