Individual provider Active NPI

Tristyn Jordan Reandelar Concengco

  • Behavior Technician
  • Orlando, FL
National Provider Identifier
1164365508
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
26-535582 Issued in FL
Practice address
3210 Corrine Dr
Orlando, FL 32803-2230
Phone
(855) 295-3276
Fax
(888) 588-2752
NPI assigned
Apr 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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 26-535582 FL Primary

Addresses

Primary practice location

3210 Corrine Dr
Orlando, FL 32803-2230

Mailing address

1333 S Mayflower Ave Ste 220
Monrovia, CA 91016-5239
Phone (818) 241-6780

Other practice location 1

6250 Hazeltine National Dr Ste 106
Orlando, FL 32822-5102
Phone (855) 295-3276

Other names 1

  • Tristyn Jordan Concengco Other name

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
26-535582FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1775779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1164365508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 S MAYFLOWER AVE STE 220",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910165239",
            "telephone_number": "818-241-6780",
            "fax_number": "888-588-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 CORRINE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328032230",
            "telephone_number": "855-295-3276",
            "fax_number": "888-588-2752"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6250 Hazeltine National Dr Ste 106",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328225102",
            "country_code": "US",
            "telephone_number": "855-295-3276",
            "fax_number": "888-588-2752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONCENGCO",
        "first_name": "TRISTYN JORDAN",
        "middle_name": "REANDELAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-10",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "26-535582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRISTYN JORDAN",
            "last_name": "CONCENGCO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.