Active NPI
Charles Jerome Butler
- Behavior Technician
- Yucaipa, CA
National Provider Identifier
1043975832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 34448 Yucaipa Blvd
Yucaipa, CA 92399-2412 - Phone
- (909) 353-7547
- NPI assigned
- Nov 5, 2021
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
34448 Yucaipa Blvd
Yucaipa, CA 92399-2412
Mailing address
29090 Oak Creek LN
Highland, CA 92346-6836
Phone (909) 346-4733
Other practice location 1
10604 N Trademark Pkwy
Rancho Cucamonga, CA 91730-5938
Phone (909) 484-2848
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": "1636070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777248000000",
"number": "1043975832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29090 OAK CREEK LN",
"city": "HIGHLAND",
"state": "CA",
"postal_code": "923466836",
"telephone_number": "909-346-4733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34448 YUCAIPA BLVD",
"city": "YUCAIPA",
"state": "CA",
"postal_code": "923992412",
"telephone_number": "909-353-7547"
}
],
"practiceLocations": [
{
"address_1": "10604 N Trademark Pkwy",
"address_purpose": "LOCATION",
"city": "Rancho Cucamonga",
"state": "CA",
"postal_code": "917305938",
"country_code": "US",
"telephone_number": "909-484-2848",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUTLER",
"first_name": "CHARLES",
"middle_name": "JEROME",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-05",
"last_updated": "2026-04-27",
"certification_date": "2026-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yucaipa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.