Individual provider Active NPI

Lauryn Carrjohnson

  • Behavior Technician
  • Antioch, CA
National Provider Identifier
1073261293
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
4732 Palomino Way
Antioch, CA 94531-9304
Phone
(510) 328-9130
NPI assigned
Mar 16, 2022
Last updated
Mar 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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 CA Primary

Addresses

Primary practice location

4732 Palomino Way
Antioch, CA 94531-9304

Mailing address

4732 Palomino Way
Antioch, CA 94531-9304
Phone (510) 328-9130

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": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1073261293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4732 PALOMINO WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945319304",
            "telephone_number": "510-328-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4732 PALOMINO WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945319304",
            "telephone_number": "510-328-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRJOHNSON",
        "first_name": "LAURYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.