Active NPI
Sierra Lynn Donegan
- Behavior Technician
- San Mateo, CA
National Provider Identifier
1033785779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- Y4393399
- Practice address
- 424 Peninsula Ave
San Mateo, CA 94401-1653 - Phone
- (650) 286-4396
- NPI assigned
- Jun 2, 2021
- Last updated
- Jun 2, 2021
- Sex
- Female
- 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 | Y4393399 | CA | Primary |
Addresses
Primary practice location
424 Peninsula Ave
San Mateo, CA 94401-1653
Mailing address
1277 Mokelumne Dr
Antioch, CA 94531-8089
Phone (858) 822-9982
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 |
|---|---|---|---|
| Y4393399 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622592000000",
"number": "1033785779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1277 MOKELUMNE DR",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945318089",
"telephone_number": "858-822-9982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 PENINSULA AVE",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944011653",
"telephone_number": "650-286-4396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONEGAN",
"first_name": "SIERRA",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-02",
"last_updated": "2021-06-02",
"certification_date": "2021-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "Y4393399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.