Individual provider Active NPI

Rudy Aguirre

  • Student in an Organized Health Care Education/Training Program
  • Van Nuys, CA
National Provider Identifier
1114464427
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
7226 Sepulveda Blvd
Van Nuys, CA 91405-2003
Phone
(818) 235-1414
Fax
(818) 945-0827
NPI assigned
Jan 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

7226 Sepulveda Blvd
Van Nuys, CA 91405-2003

Mailing address

18860 Nordhoff St
Northridge, CA 91324-3811
Phone (818) 855-1788

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

Practice roles

OrganizationSpecialtyStatusNew patients
A Change in Trajectory, Inc. PastSince Jun 1, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1114464427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18860 NORDHOFF ST",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243811",
            "telephone_number": "818-855-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7226 SEPULVEDA BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914052003",
            "telephone_number": "818-235-1414",
            "fax_number": "818-945-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUIRRE",
        "first_name": "RUDY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-24",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.