Individual provider Active NPI

Jared Friesen-Lee

  • Behavior Technician
  • Santa Clara, CA
National Provider Identifier
1073169983
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1171 Homestead Rd Ste 250
Santa Clara, CA 95050-5485
Phone
(408) 320-2590
NPI assigned
Aug 15, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

1171 Homestead Rd Ste 250
Santa Clara, CA 95050-5485

Mailing address

1462 Hicks Ave
San Jose, CA 95125-3821
Phone (512) 705-8606

Other practice location 1

1462 Hicks Ave
San Jose, CA 95125-3821
Phone (512) 705-8606

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": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1073169983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1462 HICKS AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253821",
            "telephone_number": "512-705-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 HOMESTEAD RD STE 250",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950505485",
            "telephone_number": "408-320-2590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1462 Hicks Ave",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951253821",
            "country_code": "US",
            "telephone_number": "512-705-8606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRIESEN-LEE",
        "first_name": "JARED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.