Individual provider Active NPI

Jennafer Lewis

  • Behavior Analyst
  • Rancho Cucamonga, CA
National Provider Identifier
1053950923
Registry record updated Dec 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
8300 Utica Ave Ste 259
Rancho Cucamonga, CA 91730-3852
Phone
(909) 906-1505
NPI assigned
Dec 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

8300 Utica Ave Ste 259
Rancho Cucamonga, CA 91730-3852

Mailing address

8300 Utica Ave Ste 259
Rancho Cucamonga, CA 91730-3852
Phone (909) 906-1505

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": "1577145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577145600000",
    "number": "1053950923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 UTICA AVE STE 259",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303852",
            "telephone_number": "909-906-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 UTICA AVE STE 259",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303852",
            "telephone_number": "909-906-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JENNAFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-24",
        "last_updated": "2019-12-24",
        "certification_date": "2019-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.

Verify at the official NPI Registry.