Individual provider Active NPI

Larissa Lauren Hacke

  • Behavior Technician
  • Irvine, CA
National Provider Identifier
1053099283
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
17752 Sky Park Cir
Irvine, CA 92614-6419
Phone
(949) 474-5577
NPI assigned
Jul 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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 Primary

Addresses

Primary practice location

17752 Sky Park Cir
Irvine, CA 92614-6419

Mailing address

29752 Melinda Rd Apt 2125
Rancho Santa Margarita, CA 92688-3472
Phone (949) 939-1655

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL bsanchez@ascaba.com Direct

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": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1053099283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29752 MELINDA RD APT 2125",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883472",
            "telephone_number": "949-939-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17752 SKY PARK CIR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146419",
            "telephone_number": "949-474-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKE",
        "first_name": "LARISSA",
        "middle_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "bsanchez@ascaba.com",
            "affiliation": "N",
            "endpointDescription": "Office Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17752 Sky Park Cir",
            "city": "Irvine",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926146419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.

Verify at the official NPI Registry.