Individual provider Active NPI

Tiara Redick, BA, RBT

  • Behavior Technician
  • Sacramento, CA
National Provider Identifier
1124517842
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-17-43035 Issued in CA
Practice address
9755 Lincoln Village Dr
Sacramento, CA 95827-3334
Phone
(916) 363-6103
NPI assigned
May 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

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 RBT-17-43035 CA Primary

Addresses

Primary practice location

9755 Lincoln Village Dr
Sacramento, CA 95827-3334

Mailing address

9755 Lincoln Village Dr
Sacramento, CA 95827-3334
Phone (916) 363-6103

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
RBT-17-43035CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1124517842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9755 LINCOLN VILLAGE DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958273334",
            "telephone_number": "916-363-6103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9755 LINCOLN VILLAGE DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958273334",
            "telephone_number": "916-363-6103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDICK",
        "first_name": "TIARA",
        "credential": "BA, RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-17-43035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.