Individual provider Active NPI

Caitlynn Star Cavazos

  • Assistant Behavior Analyst
  • Rancho Cucamonga, CA
National Provider Identifier
1093325680
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
Practice address
10604 N Trademark Pkwy
Rancho Cucamonga, CA 91730-5938
Phone
(909) 476-5747
NPI assigned
Aug 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X Primary

Addresses

Primary practice location

10604 N Trademark Pkwy
Rancho Cucamonga, CA 91730-5938

Mailing address

2222 Jornada Dr
Perris, CA 92571-3344
Phone (760) 684-2460

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": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1093325680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 JORNADA DR",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925713344",
            "telephone_number": "760-684-2460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10604 N TRADEMARK PKWY",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305938",
            "telephone_number": "909-476-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVAZOS",
        "first_name": "CAITLYNN",
        "middle_name": "STAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.