Active NPI
Chrystal Jolicoeur
- Behavior Technician
- Eugene, OR
National Provider Identifier
1073178497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- ABA-IN-10196296
- Practice address
- 555 E 15TH Ave
Eugene, OR 97401-4314 - Phone
- (541) 345-0805
- NPI assigned
- May 1, 2019
- Sex
- Female
- 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 | ABA-IN-10196296 | OR | Primary |
Addresses
Primary practice location
555 E 15TH Ave
Eugene, OR 97401-4314
Mailing address
PO Box 1143
Marcola, OR 97454-1143
Phone (541) 852-9959
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 |
|---|---|---|---|
| ABA-IN-10196296 | OR | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556668800000",
"number": "1073178497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1143",
"city": "MARCOLA",
"state": "OR",
"postal_code": "974541143",
"telephone_number": "541-852-9959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 E 15TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974014314",
"telephone_number": "541-345-0805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLICOEUR",
"first_name": "CHRYSTAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-01",
"last_updated": "2019-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "OR",
"license": "ABA-IN-10196296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.