Active NPI
Prabhjeet Kaur
- Behavior Technician
- Stockton, CA
National Provider Identifier
1023891777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- JOG13801
- Practice address
- 1811 Grand Canal Blvd
Stockton, CA 95207-8155 - Phone
- (209) 242-4990
- NPI assigned
- Aug 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | JOG13801 | CA | Primary |
Addresses
Primary practice location
1811 Grand Canal Blvd
Stockton, CA 95207-8155
Mailing address
350 Fairway Dr Ste 101
Deerfield Beach, FL 33441-1834
Phone (888) 880-9270
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
| License | State | Type | Specialty |
|---|---|---|---|
| JOG13801 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692144000000",
"number": "1023891777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 FAIRWAY DR STE 101",
"city": "DEERFIELD BEACH",
"state": "FL",
"postal_code": "334411834",
"telephone_number": "888-880-9270",
"fax_number": "954-342-0273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1811 GRAND CANAL BLVD",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952078155",
"telephone_number": "209-242-4990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUR",
"first_name": "PRABHJEET",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-16",
"last_updated": "2023-08-16",
"certification_date": "2023-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "CA",
"license": "JOG13801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.