Active NPI
Vanessa Elizabeth Archuleta
- Behavior Analyst
- Fairfield, CA
National Provider Identifier
1083050629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- D4094674
- Practice address
- 2864 Candleberry Way
Fairfield, CA 94533-7029 - Phone
- (707) 816-2494
- NPI assigned
- May 21, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Behavior Analyst | 103K00000X | D4094674 | CA | Primary |
Addresses
Primary practice location
2864 Candleberry Way
Fairfield, CA 94533-7029
Mailing address
2864 Candleberry Way
Fairfield, CA 94533-7029
Phone (707) 816-2494
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 |
|---|---|---|---|
| D4094674 | CA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476748800000",
"number": "1083050629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2864 CANDLEBERRY WAY",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945337029",
"telephone_number": "707-816-2494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2864 CANDLEBERRY WAY",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945337029",
"telephone_number": "707-816-2494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARCHULETA",
"first_name": "VANESSA",
"middle_name": "ELIZABETH",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-21",
"last_updated": "2016-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "D4094674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.