Active NPI
Serenity Rae Rogers
- Behavior Technician
- Vacaville, CA
National Provider Identifier
1104533637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- F4438789
- Practice address
- 161 Butcher Rd Ste B
Vacaville, CA 95687-5685 - Phone
- (760) 900-8405
- NPI assigned
- Nov 3, 2022
- 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 | F4438789 | CA | Primary |
Addresses
Primary practice location
161 Butcher Rd Ste B
Vacaville, CA 95687-5685
Mailing address
555 Elmira Rd Apt 85
Vacaville, CA 95687-7044
Phone (760) 900-8405
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
| License | State | Type | Specialty |
|---|---|---|---|
| F4438789 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667433600000",
"number": "1104533637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 ELMIRA RD APT 85",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956877044",
"telephone_number": "760-900-8405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 BUTCHER RD STE B",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956875685",
"telephone_number": "760-900-8405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGERS",
"first_name": "SERENITY",
"middle_name": "RAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-03",
"last_updated": "2022-11-03",
"certification_date": "2022-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "F4438789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vacaville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.