Active NPI
Dennise Olivas
- Behavior Technician
- Mecca, CA
National Provider Identifier
1093564544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 90125 70TH Ave SPC 4
Mecca, CA 92254-4511 - Phone
- (760) 620-8789
- NPI assigned
- May 16, 2024
- Sex
- Female
- Sole proprietor
- No
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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
90125 70TH Ave SPC 4
Mecca, CA 92254-4511
Mailing address
PO Box 3015
Mecca, CA 92254-8015
Phone (760) 620-8789
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": "1715817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715817600000",
"number": "1093564544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3015",
"city": "MECCA",
"state": "CA",
"postal_code": "922548015",
"telephone_number": "760-620-8789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90125 70TH AVE SPC 4",
"city": "MECCA",
"state": "CA",
"postal_code": "922544511",
"telephone_number": "760-620-8789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVAS",
"first_name": "DENNISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-16",
"last_updated": "2024-05-16",
"certification_date": "2024-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mecca, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.