Individual provider Active NPI

Sarah Angelina Stewart

  • Behavior Technician
  • Pomona, CA
National Provider Identifier
1124622626
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
21 Rancho Camino Dr Ste 108
Pomona, CA 91766-7020
Phone
(855) 223-7123
NPI assigned
Nov 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X F7747193 CA
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

21 Rancho Camino Dr Ste 108
Pomona, CA 91766-7020

Mailing address

PO Box 33568
San Diego, CA 92163-3568
Phone (855) 223-7123

Other practice location 1

879 W 190th St Ste 400
Gardena, CA 90248-4223
Phone (310) 692-4229

Other identifiers 1

IdentifierTypeStateIssuer
F7747193OtherCADEPARTMENT OF MOTOR VEHICLES

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

LicenseStateTypeSpecialty
F7747193CAMDAssistant Behavior Analyst

NPI Registry JSON

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1124622626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33568",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921633568",
            "telephone_number": "855-223-7123",
            "fax_number": "619-374-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 RANCHO CAMINO DR STE 108",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917667020",
            "telephone_number": "855-223-7123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "879 W 190th St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Gardena",
            "state": "CA",
            "postal_code": "902484223",
            "country_code": "US",
            "telephone_number": "310-692-4229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "SARAH",
        "middle_name": "ANGELINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-24",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "CA",
            "license": "F7747193",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF MOTOR VEHICLES",
            "identifier": "F7747193",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

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