Michelle Servin, R1193480315

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

802 Magnolia Ave Ste 202
Corona, CA 92879-3144

Phone

(951) 686-2020

NPI assigned

May 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1073968780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3548 ATCHISON CIR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035166",
            "telephone_number": "951-256-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 MAGNOLIA AVE STE 202",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793144",
            "telephone_number": "951-686-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVIN",
        "first_name": "MICHELLE",
        "credential": "R1193480315",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-01",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Serna
• Lisa M Serrano, C.M.T
• Salena Ann Serrano, M.S.
• Celeste Serrato
• Justina Servantes
• Seth Bernstein OD and Lisa Benham OD Inc
• Cameron Lorraine Severns
• Jordyn Seward
• Manouchehr Seyfzadeh, M.D., PH.D.
• SG Homecare,Inc. (Stance Health Solutions)

• Behavior Technician in Corona, CA
• Providers in Corona, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; 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.