Individual provider Active NPI

Cheyelle B Della

  • Behavior Technician
  • Gresham, OR
National Provider Identifier
1104535442
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1112 NW 15TH St Apt B110
Gresham, OR 97030-4961
Phone
(971) 363-7788
NPI assigned
Nov 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 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 Primary

Addresses

Primary practice location

1112 NW 15TH St Apt B110
Gresham, OR 97030-4961

Mailing address

1200 Concord Ave Ste 100
Concord, CA 94520-4969
Phone (510) 268-8120

Other practice location 1

1200 Concord Ave Ste 100
Concord, CA 94520-4969
Phone (510) 268-8120

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": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1104535442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CONCORD AVE STE 100",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204969",
            "telephone_number": "510-268-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 NW 15TH ST APT B110",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970304961",
            "telephone_number": "971-363-7788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Concord Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945204969",
            "country_code": "US",
            "telephone_number": "510-268-8120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELLA",
        "first_name": "CHEYELLE",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.