Individual provider Active NPI

Stacy Juliette Arellano

  • Behavior Technician
  • Placentia, CA
National Provider Identifier
1104696590
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
701 W Kimberly Ave Ste 125
Placentia, CA 92870-6346
Phone
(714) 203-6595
Fax
(714) 716-4433
NPI assigned
Jan 5, 2024
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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 NU Primary

Addresses

Primary practice location

701 W Kimberly Ave Ste 125
Placentia, CA 92870-6346

Mailing address

12350 Marshall Ave Apt 214
Chino, CA 91710-2545
Phone (909) 325-5489

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": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1104696590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12350 MARSHALL AVE APT 214",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102545",
            "telephone_number": "909-325-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W KIMBERLY AVE STE 125",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928706346",
            "telephone_number": "714-203-6595",
            "fax_number": "714-716-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARELLANO",
        "first_name": "STACY",
        "middle_name": "JULIETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.

Verify at the official NPI Registry.