Individual provider Active NPI

Ashley Trinee Qualls Latiker

  • Behavior Technician
  • Fullerton, CA
National Provider Identifier
1104461904
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
713 W Commonwealth Ave Ste C
Fullerton, CA 92832-1612
Phone
(714) 879-4274
Fax
(714) 879-2274
NPI assigned
Nov 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

713 W Commonwealth Ave Ste C
Fullerton, CA 92832-1612

Mailing address

PO Box 721
Bellflower, CA 90707-0721
Phone (562) 584-5145

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": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1104461904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 721",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907070721",
            "telephone_number": "562-584-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 W COMMONWEALTH AVE STE C",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321612",
            "telephone_number": "714-879-4274",
            "fax_number": "714-879-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUALLS LATIKER",
        "first_name": "ASHLEY",
        "middle_name": "TRINEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; 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.