Active NPI
Wasem Staneksay
- Behavior Technician
- San Diego, CA
National Provider Identifier
1063940419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 15-07327
- Practice address
- 10065 Old Grove Rd Ste 200
San Diego, CA 92131-1664 - Phone
- (858) 444-8823
- NPI assigned
- May 30, 2017
- Sex
- Male
- 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 | 15-07327 | CA | Primary |
Addresses
Primary practice location
10065 Old Grove Rd Ste 200
San Diego, CA 92131-1664
Mailing address
10143 Zapata Ave
San Diego, CA 92126-1121
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 |
|---|---|---|---|
| 15-07327 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496102400000",
"number": "1063940419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10143 ZAPATA AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921261121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10065 OLD GROVE RD STE 200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921311664",
"telephone_number": "858-444-8823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANEKSAY",
"first_name": "WASEM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-30",
"last_updated": "2017-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "15-07327",
"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 May 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.