Jose De la Cruz Sr., ABA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0450343237 Issued in NJ

Practice address

61 Fenner Ave
Clifton, NJ 07013-1049

Phone

(973) 510-4089

NPI assigned

Feb 3, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Jose De la Cruz Sr. Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Business Administration

State licenses

Practice roles

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

• Clear Choice Behavioral Healthcare, LLC

  • Clinic/Center
  • Clifton, NJ
  • NPI 1740747351
  NPD (past) Authorized official

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

{
    "created_epoch": "1549152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549152000000",
    "number": "1164987202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 FENNER AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131049",
            "telephone_number": "973-510-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 FENNER AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131049",
            "telephone_number": "973-510-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "JOSE",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "ABA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-03",
        "last_updated": "2019-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "0450343237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSE",
            "last_name": "CRUZ",
            "middle_name": "DE LA",
            "prefix": "MR.",
            "suffix": "SR.",
            "credential": "ABA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• DDD Neurology & Electrodiagnostics PLLC
• Lisa De Candio
• Melanie Sharen De Dios
• De la Cerna PT,PC
• Angel Ramon De la Cruz, MD
• MC Gucken De Leon, PT
• Michael Andrew De Poto, D.D.S.
• Leah Patricia Deabreu, LPN
• Shadae Dean
• David A Debell

• Behavior Analyst in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Behavior Analyst in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2019; 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.