Active NPI
Nicole Shannon Herrera, BCABA
- Behavior Analyst
- Fountain, CO
National Provider Identifier
1093005001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 0-11-4012
- Practice address
- 8319 Newbury Way
Fountain, CO 80817-4049 - Phone
- (850) 630-3358
- NPI assigned
- Apr 11, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 0-11-4012 | CO | Primary |
Addresses
Primary practice location
8319 Newbury Way
Fountain, CO 80817-4049
Mailing address
8319 Newbury Way
Fountain, CO 80817-4049
Phone (850) 630-3358
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0-11-4012 | Other | CO | BCABA CERIFICATION NUMBER (BOARD CERTIFIED ASSISTANT BEHAVIOR ANALYST) |
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": "1302480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302480000000",
"number": "1093005001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8319 NEWBURY WAY",
"city": "FOUNTAIN",
"state": "CO",
"postal_code": "808174049",
"telephone_number": "850-630-3358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8319 NEWBURY WAY",
"city": "FOUNTAIN",
"state": "CO",
"postal_code": "808174049",
"telephone_number": "850-630-3358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRERA",
"first_name": "NICOLE",
"middle_name": "SHANNON",
"name_prefix": "Mrs.",
"credential": "BCABA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-11",
"last_updated": "2011-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CO",
"license": "0-11-4012",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCABA CERIFICATION NUMBER (BOARD CERTIFIED ASSISTANT BEHAVIOR ANALYST)",
"identifier": "0-11-4012",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fountain, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.