Individual provider Active NPI

Annie Sengvanpheng

  • Behavior Technician
  • Sacramento, CA
National Provider Identifier
1154114890
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2800 Stonecreek Dr
Sacramento, CA 95833-1634
Phone
(916) 363-6103
Fax
(916) 244-0594
NPI assigned
May 26, 2025
Last updated
May 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 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

2800 Stonecreek Dr
Sacramento, CA 95833-1634

Mailing address

9755 Lincoln Village Dr
Sacramento, CA 95827-3334
Phone (916) 363-6103

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Kids PastSince Jun 3, 2025 Accepting new patients
Advance Kids PastSince Jun 3, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1748217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748217600000",
    "number": "1154114890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9755 LINCOLN VILLAGE DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958273334",
            "telephone_number": "916-363-6103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 STONECREEK DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958331634",
            "telephone_number": "916-363-6103",
            "fax_number": "916-244-0594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENGVANPHENG",
        "first_name": "ANNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-26",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.