Active NPI
Yuyada Tesfay
- Behavior Technician
- Broadlands, VA
National Provider Identifier
1144930819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-218569
- Practice address
- 21576 Iredell Ter
Broadlands, VA 20148-5033 - Phone
- (510) 738-7709
- NPI assigned
- Dec 2, 2022
- Sex
- Female
- 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 | RBT-22-218569 | VA | Primary |
Addresses
Primary practice location
21576 Iredell Ter
Broadlands, VA 20148-5033
Mailing address
21576 Iredell Ter
Broadlands, VA 20148-5033
Phone (510) 738-7709
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 |
|---|---|---|---|
| RBT-22-218569 | VA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669939200000",
"number": "1144930819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21576 IREDELL TER",
"city": "BROADLANDS",
"state": "VA",
"postal_code": "201485033",
"telephone_number": "510-738-7709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21576 IREDELL TER",
"city": "BROADLANDS",
"state": "VA",
"postal_code": "201485033",
"telephone_number": "510-738-7709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TESFAY",
"first_name": "YUYADA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-02",
"last_updated": "2022-12-02",
"certification_date": "2022-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": "RBT-22-218569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broadlands, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.