Individual provider Active NPI

Stefanie Alison Mraule, RBT

  • Behavior Technician
  • San Clemente, CA
National Provider Identifier
1174091920
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-18-70103 Issued in CA
Practice address
3030 Calle Frontera
San Clemente, CA 92673-3009
Phone
(949) 272-6146
Fax
(888) 847-8864
NPI assigned
Nov 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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 RBT-18-70103 CA Primary

Addresses

Primary practice location

3030 Calle Frontera
San Clemente, CA 92673-3009

Mailing address

3030 Calle Frontera
San Clemente, CA 92673-3009

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
RBT-18-70103CAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Adrienne M. Silva Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1174091920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 CALLE FRONTERA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926733009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 CALLE FRONTERA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926733009",
            "telephone_number": "949-272-6146",
            "fax_number": "888-847-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MRAULE",
        "first_name": "STEFANIE",
        "middle_name": "ALISON",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-09",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-18-70103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.