Individual provider Active NPI

Edward George Matovu

  • Behavior Technician
  • Los Angeles, CA
National Provider Identifier
1144032418
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
11150 W Olympic Blvd Ste 11150W
Los Angeles, CA 90064-1817
Phone
(510) 397-2851
NPI assigned
Jan 23, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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 Primary

Addresses

Primary practice location

11150 W Olympic Blvd Ste 11150W
Los Angeles, CA 90064-1817

Mailing address

11150 W Olympic Blvd Ste 11150W
Los Angeles, CA 90064-1817
Phone (510) 397-2851

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

NPI Registry JSON

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1144032418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11150 W OLYMPIC BLVD STE 11150W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641817",
            "telephone_number": "510-397-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11150 W OLYMPIC BLVD STE 11150W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641817",
            "telephone_number": "510-397-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOVU",
        "first_name": "EDWARD",
        "middle_name": "GEORGE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.