Active NPI
Nav Ryan Khanna
- Behavior Technician
- San Mateo, CA
National Provider Identifier
1124704473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 00018661
- Practice address
- 631 S B St
San Mateo, CA 94401-4120 - Phone
- (877) 242-2884
- Fax
- (559) 225-2083
- NPI assigned
- Jun 22, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 00018661 | CA | Primary |
Addresses
Primary practice location
631 S B St
San Mateo, CA 94401-4120
Mailing address
2354 Powell St
Emeryville, CA 94608-1738
Phone (877) 242-2884
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00018661 | CA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Intervention Association | Past | 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.
-
- Early Intervention Provider Agency
- Oakland, CA
- NPI 1609199512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687392000000",
"number": "1124704473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2354 POWELL ST",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081738",
"telephone_number": "877-242-2884",
"fax_number": "559-225-2083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 S B ST",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944014120",
"telephone_number": "877-242-2884",
"fax_number": "559-225-2083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHANNA",
"first_name": "NAV",
"middle_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-22",
"last_updated": "2023-06-22",
"certification_date": "2023-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "00018661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.