Individual provider Active NPI

Yanelis Hernandez Gonzalez

  • Behavior Technician
  • Port St Lucie, FL
National Provider Identifier
1043030059
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24378436
Practice address
426 NE Mainsail St
Port St Lucie, FL 34983-1265
Phone
(772) 256-3456
NPI assigned
Oct 14, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24378436 Primary

Addresses

Primary practice location

426 NE Mainsail St
Port St Lucie, FL 34983-1265

Mailing address

426 NE Mainsail St
Port St Lucie, FL 34983-1265
Phone (772) 256-3456

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": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1043030059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 NE MAINSAIL ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349831265",
            "telephone_number": "772-256-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 NE MAINSAIL ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349831265",
            "telephone_number": "772-256-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ GONZALEZ",
        "first_name": "YANELIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT-24378436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.