Individual provider Active NPI

Lauren Rea Bacchus

  • Behavior Technician
  • Camarillo, CA
National Provider Identifier
1083365837
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
5340 Buena Mesa CT
Camarillo, CA 93012-5312
Phone
(805) 427-0508
NPI assigned
Jan 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 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 Primary

Addresses

Primary practice location

5340 Buena Mesa CT
Camarillo, CA 93012-5312

Mailing address

5340 Buena Mesa CT
Camarillo, CA 93012-5312
Phone (805) 427-0508

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Camarillo Direct

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": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1083365837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 BUENA MESA CT",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125312",
            "telephone_number": "805-427-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 BUENA MESA CT",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125312",
            "telephone_number": "805-427-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCHUS",
        "first_name": "LAUREN",
        "middle_name": "REA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Camarillo",
            "affiliation": "N",
            "endpointDescription": "Westlake",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "i dont know",
            "address_1": "5340 Buena Mesa Ct",
            "city": "Camarillo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930125312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.