Individual provider Active NPI

Lizbeth Corrales

  • Behavior Technician
  • San Diego, CA
National Provider Identifier
1104326883
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3110 Camino del Rio S Ste 307
San Diego, CA 92108-3832
Phone
(619) 795-9925
NPI assigned
Feb 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

3110 Camino del Rio S Ste 307
San Diego, CA 92108-3832

Mailing address

3110 Camino del Rio S Ste 307
San Diego, CA 92108-3832
Phone (619) 795-9925

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": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1104326883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 CAMINO DEL RIO S STE 307",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083832",
            "telephone_number": "619-795-9925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 CAMINO DEL RIO S STE 307",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083832",
            "telephone_number": "619-795-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRALES",
        "first_name": "LIZBETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "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 Mar 6, 2018; 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.