Individual provider Active NPI

Lavergne Shenee Flournoy, RBT

  • Behavior Technician
  • San Diego, CA
National Provider Identifier
1093447963
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
15-10682 Issued in CA
Practice address
10680 Treena St Ste 170
San Diego, CA 92131-2443
Phone
(858) 432-4749
Fax
(858) 432-4750
NPI assigned
Jun 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 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 15-10682 CA Primary

Addresses

Primary practice location

10680 Treena St Ste 170
San Diego, CA 92131-2443

Mailing address

4290 50TH St Apt a
San Diego, CA 92115-5019
Phone (619) 674-5509

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

LicenseStateTypeSpecialty
15-10682CAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunny Days of California PastSince Jul 3, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1093447963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 50TH ST APT A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921155019",
            "telephone_number": "619-674-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10680 TREENA ST STE 170",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921312443",
            "telephone_number": "858-432-4749",
            "fax_number": "858-432-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOURNOY",
        "first_name": "LAVERGNE",
        "middle_name": "SHENEE",
        "name_prefix": "Ms.",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "15-10682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.