Active NPI
Lava Josephine Khurshid
- Behavior Technician
- San Diego, CA
National Provider Identifier
1043867310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-19-92191
- Practice address
- 11665 Avena PL Ste 204
San Diego, CA 92128-2428 - Phone
- (858) 200-8480
- NPI assigned
- Aug 21, 2019
- 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 | RBT-19-92191 | CA | Primary |
Addresses
Primary practice location
11665 Avena PL Ste 204
San Diego, CA 92128-2428
Mailing address
11665 Avena PL Ste 204
San Diego, CA 92128-2428
Phone (858) 200-8480
Other practice location 1
11665 Avena Pl Ste 204
San Diego, CA 92128-2428
Phone (858) 200-8480
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 |
|---|---|---|---|
| RBT-19-92191 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566345600000",
"number": "1043867310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11665 AVENA PL STE 204",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921282428",
"telephone_number": "858-200-8480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11665 AVENA PL STE 204",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921282428",
"telephone_number": "858-200-8480"
}
],
"practiceLocations": [
{
"address_1": "11665 Avena Pl Ste 204",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921282428",
"country_code": "US",
"telephone_number": "858-200-8480",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHURSHID",
"first_name": "LAVA",
"middle_name": "JOSEPHINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-21",
"last_updated": "2019-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-19-92191",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.