Individual provider Active NPI

Thomas Harvey, BEHAVIOR TECHNICIAN

  • Behavior Technician
  • Indio, CA
National Provider Identifier
1023547650
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
47825 Oasis St
Indio, CA 92201-6950
Phone
(909) 637-5107
NPI assigned
Jun 7, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1239030916 CA

Addresses

Primary practice location

47825 Oasis St
Indio, CA 92201-6950

Mailing address

47825 Oasis St
Indio, CA 92201-6950

Other practice location 1

141 N Arrowhead Ave
San Bernardino, CA 92408-1016
Phone (909) 963-5355

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

State licenses

LicenseStateTypeSpecialty
R1239030916CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1023547650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47825 OASIS ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922016950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47825 OASIS ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922016950",
            "telephone_number": "909-637-5107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 N Arrowhead Ave",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924081016",
            "country_code": "US",
            "telephone_number": "909-963-5355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARVEY",
        "first_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "BEHAVIOR TECHNICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1239030916",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.