Individual provider Active NPI

Moises Cristo Augusto Romualdo

  • Behavior Technician
  • Garden Grove, CA
National Provider Identifier
1174334460
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
12062 Valley View St Ste 220
Garden Grove, CA 92845-1739
Phone
(562) 356-8600
NPI assigned
Jan 15, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 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

12062 Valley View St Ste 220
Garden Grove, CA 92845-1739

Mailing address

727 S Lyon St Apt D6
Santa Ana, CA 92705-4267
Phone (657) 356-4297

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

NPI Registry JSON

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

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1174334460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 S LYON ST APT D6",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054267",
            "telephone_number": "657-356-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12062 VALLEY VIEW ST STE 220",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928451739",
            "telephone_number": "562-356-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMUALDO",
        "first_name": "MOISES",
        "middle_name": "CRISTO AUGUSTO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.