Individual provider Active NPI

Angel Emmanuel Vazquez

  • Behavior Analyst
  • Vallejo, CA
National Provider Identifier
1134052954
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
Y9295344 Issued in CA
Practice address
150 Glen Cove Marina Rd E Ste 102
Vallejo, CA 94591-7237
Phone
(877) 910-6538
NPI assigned
Jun 3, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Y9295344 CA Primary

Addresses

Primary practice location

150 Glen Cove Marina Rd E Ste 102
Vallejo, CA 94591-7237

Mailing address

150 Glen Cove Marina Rd E Ste 102
Vallejo, CA 94591-7237
Phone (877) 910-6538

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
Y9295344CAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1780444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1134052954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 GLEN COVE MARINA RD E STE 102",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917237",
            "telephone_number": "877-910-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 GLEN COVE MARINA RD E STE 102",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917237",
            "telephone_number": "877-910-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "ANGEL",
        "middle_name": "EMMANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "Y9295344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.